Provider Demographics
NPI:1184389942
Name:WEINROTH, GAIL P (LPC)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:P
Last Name:WEINROTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ECHO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4302
Mailing Address - Country:US
Mailing Address - Phone:201-259-9533
Mailing Address - Fax:
Practice Address - Street 1:5 ECHO RIDGE RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4302
Practice Address - Country:US
Practice Address - Phone:201-259-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00558400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor