Provider Demographics
NPI:1740511799
Name:GAHAGAN, ALANE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALANE
Middle Name:
Last Name:GAHAGAN
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 1:34 ROUTE 403
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524-3323
Mailing Address - Country:US
Mailing Address - Phone:845-424-6274
Mailing Address - Fax:845-424-6274
Practice Address - Street 1:34 ROUTE 403
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-3323
Practice Address - Country:US
Practice Address - Phone:845-424-6274
Practice Address - Fax:845-424-6274
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0761051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12019154OtherCAQH
NY076105OtherLCSW