Provider Demographics
NPI:1134390180
Name:LOVALLO, GAIL PATRICIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:PATRICIA
Last Name:LOVALLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:GAIL
Other - Middle Name:PATRICIA
Other - Last Name:GIANCOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 ACORN DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2219
Mailing Address - Country:US
Mailing Address - Phone:732-729-3600
Mailing Address - Fax:732-435-0222
Practice Address - Street 1:294 BROAD ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2152
Practice Address - Country:US
Practice Address - Phone:732-320-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC010913001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical