Provider Demographics
NPI:1245985340
Name:DUFFY, GAIL (LPC)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:DUFFY
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 1:409 SECOND AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3625
Mailing Address - Country:US
Mailing Address - Phone:267-669-0300
Mailing Address - Fax:
Practice Address - Street 1:3031 WALTON RD STE 300
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2369
Practice Address - Country:US
Practice Address - Phone:267-669-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014144101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)