Healthcare Provider Details

I. General information

NPI: 1437019858
Provider Name (Legal Business Name): YVONNE M. GAYLE LCSW, CASAC-M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12911 JAMAICA AVE APT 2F
RICHMOND HILL NY
11418-2695
US

IV. Provider business mailing address

PO BOX 120280
SAINT ALBANS NY
11412-0280
US

V. Phone/Fax

Practice location:
  • Phone: 347-224-5014
  • Fax:
Mailing address:
  • Phone: 929-725-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100722
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number30448
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: