Provider Demographics
NPI:1295942050
Name:GUNN, LORI SABINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:SABINA
Last Name:GUNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WHITNEY STREET EXT
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3768
Mailing Address - Country:US
Mailing Address - Phone:203-247-5492
Mailing Address - Fax:
Practice Address - Street 1:585 N BARRY AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1633
Practice Address - Country:US
Practice Address - Phone:203-247-5492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR076557-11041C0700X
CT0056091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical