Healthcare Provider Details

I. General information

NPI: 1225112832
Provider Name (Legal Business Name): GAIL B. ADLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 EAST ST SUITE 304
PLAINVILLE CT
06062-2367
US

IV. Provider business mailing address

74 EAST ST SUITE 304
PLAINVILLE CT
06062-2367
US

V. Phone/Fax

Practice location:
  • Phone: 860-410-1877
  • Fax: 860-410-1878
Mailing address:
  • Phone: 860-410-1877
  • Fax: 860-410-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002563
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier002563
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerLICENSED CLINICAL SOCIAL
# 2
Identifier140002563 CT 01
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerANTHEM BLUE CROSS/BLUE SH
# 3
Identifier299121
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerMHN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: