Provider Demographics
NPI:1457402778
Name:CALEV, GILA (LCSW)
Entity Type:Individual
Prefix:
First Name:GILA
Middle Name:
Last Name:CALEV
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 1:111 SMITHTOWN BYP
Mailing Address - Street 2:SUITE 119
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2524
Mailing Address - Country:US
Mailing Address - Phone:631-863-2469
Mailing Address - Fax:631-246-5469
Practice Address - Street 1:111 SMITHTOWN BYP
Practice Address - Street 2:SUITE 119
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2524
Practice Address - Country:US
Practice Address - Phone:631-863-2469
Practice Address - Fax:631-246-5469
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNE3411Medicare ID - Type Unspecified