Healthcare Provider Details

I. General information

NPI: 1265947444
Provider Name (Legal Business Name): GABRIELLE LIND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2017
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SUNSET VIEW DR
WEST NYACK NY
10994-2018
US

IV. Provider business mailing address

30 SUNSET VIEW DR
WEST NYACK NY
10994-2018
US

V. Phone/Fax

Practice location:
  • Phone: 929-324-6196
  • Fax:
Mailing address:
  • Phone: 929-324-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093295-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: