Provider Demographics
NPI:1811941156
Name:GILBERT, MARICELLA D (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:MARICELLA
Middle Name:D
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 E 28TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6303
Mailing Address - Country:US
Mailing Address - Phone:718-282-2871
Mailing Address - Fax:347-789-4158
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 410C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:917-518-9725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR058487-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02435394Medicaid
NY02435394Medicaid