Provider Demographics
NPI:1750007043
Name:PSYCHOTHERAPY SERVICES BY GAIL BRONSTEIN DECINA LLC
Entity type:Organization
Organization Name:PSYCHOTHERAPY SERVICES BY GAIL BRONSTEIN DECINA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DECINA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:549-540-7415
Mailing Address - Street 1:17 WILLOWBROOK LN APT 102
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1644
Mailing Address - Country:US
Mailing Address - Phone:954-540-7415
Mailing Address - Fax:
Practice Address - Street 1:17 WILLOWBROOK LN APT 102
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1644
Practice Address - Country:US
Practice Address - Phone:561-556-2738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty