Healthcare Provider Details

I. General information

NPI: 1023543485
Provider Name (Legal Business Name): HOLLY C GAUL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 HIGHWAY 35 STE 205
MANASQUAN NJ
08736-1900
US

IV. Provider business mailing address

2520 HIGHWAY 35 STE 205
MANASQUAN NJ
08736-1900
US

V. Phone/Fax

Practice location:
  • Phone: 732-278-6651
  • Fax: 732-974-5540
Mailing address:
  • Phone: 732-278-6651
  • Fax: 732-974-5540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC01309600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: