Provider Demographics
NPI:1669063848
Name:ZUBAY, BRENDA GAYLE (LMSW)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:GAYLE
Last Name:ZUBAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 BLUE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-3550
Mailing Address - Country:US
Mailing Address - Phone:832-277-5882
Mailing Address - Fax:
Practice Address - Street 1:244 5TH AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7934
Practice Address - Country:US
Practice Address - Phone:518-768-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078893104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker