Provider Demographics
NPI:1649055302
Name:SERWATIEN, GABRIELLA (LMSW)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:SERWATIEN
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 SUNFISH LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5012
Mailing Address - Country:US
Mailing Address - Phone:845-405-1404
Mailing Address - Fax:
Practice Address - Street 1:30 HARRIMAN DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2410
Practice Address - Country:US
Practice Address - Phone:845-717-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126667-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker