Provider Demographics
NPI:1457567885
Name:GIGLIO, MARY (MA, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:GIGLIO
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:GIGLIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMHC, NCC
Mailing Address - Street 1:427 E 89TH ST
Mailing Address - Street 2:APT. 3J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6764
Mailing Address - Country:US
Mailing Address - Phone:917-701-6574
Mailing Address - Fax:
Practice Address - Street 1:80 5TH AVE
Practice Address - Street 2:SUITE 903-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8002
Practice Address - Country:US
Practice Address - Phone:646-213-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002439-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health