Provider Demographics
NPI:1255389490
Name:SHAY, GALE ANN (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:GALE
Middle Name:ANN
Last Name:SHAY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W MAIN STREET
Mailing Address - Street 2:PO BOX 7241
Mailing Address - City:MOUNT JEWETT
Mailing Address - State:PA
Mailing Address - Zip Code:16740
Mailing Address - Country:US
Mailing Address - Phone:814-778-5901
Mailing Address - Fax:
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:SUITE 602
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2025
Practice Address - Country:US
Practice Address - Phone:814-362-2136
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-013711-L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker