Healthcare Provider Details

I. General information

NPI: 1265594667
Provider Name (Legal Business Name): MAUREEN GELLER L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 UNION ST #3D
BROOKLYN NY
11215-1116
US

IV. Provider business mailing address

630 UNION ST #3D
BROOKLYN NY
11215-1116
US

V. Phone/Fax

Practice location:
  • Phone: 718-398-7481
  • Fax: 718-857-5055
Mailing address:
  • Phone: 718-398-7481
  • Fax: 718-857-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberR047179-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR047179-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: