Provider Demographics
NPI:1932397148
Name:YORK, GAIL MAC RAE
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:MAC RAE
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 GROVER AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5641
Mailing Address - Country:US
Mailing Address - Phone:407-647-1535
Mailing Address - Fax:
Practice Address - Street 1:905 GROVER AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5641
Practice Address - Country:US
Practice Address - Phone:407-647-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1164581633OtherSCMHC