Healthcare Provider Details

I. General information

NPI: 1982188835
Provider Name (Legal Business Name): NINA GILBERT PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 DORA ST APT 4
STAMFORD CT
06902-9407
US

IV. Provider business mailing address

14 DORA ST APT 4
STAMFORD CT
06902-9407
US

V. Phone/Fax

Practice location:
  • Phone: 704-281-3411
  • Fax:
Mailing address:
  • Phone: 704-281-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NINA GILBERT
Title or Position: THERAPIST
Credential: LCSW
Phone: 704-281-3411