Provider Demographics
NPI:1841288073
Name:GESTALT ASSOCIATES FOR PSYCHOTHERAPY
Entity type:Organization
Organization Name:GESTALT ASSOCIATES FOR PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIORANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-689-7740
Mailing Address - Street 1:201 E 34TH ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4765
Mailing Address - Country:US
Mailing Address - Phone:212-689-7740
Mailing Address - Fax:212-689-7745
Practice Address - Street 1:201 E 34TH ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4765
Practice Address - Country:US
Practice Address - Phone:212-689-7740
Practice Address - Fax:212-689-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0135791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN3W311Medicare ID - Type Unspecified