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General NPI Number Information
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NPI Number | 1003092958
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Entity Type | Organization
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Legal Business Name | LAURIE D GILKES LCSW PC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 330 E 79TH ST SUITE 1G
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City | NEW YORK
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State | NY
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Zip | 10075-0966
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Country | US
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Telephone | 212-737-0560
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Fax | 212-737-0560
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Provider Business Mailing Address
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Address Line | 330 E 79TH ST SUITE 1G
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City | NEW YORK
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State | NY
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Zip | 10075-0966
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Country | US
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Telephone | 212-737-0560
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Fax | 212-737-0560
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAURIE D GILKES
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Credential | LCSW PC
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Telephone | 212-737-0560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PR012668-1
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License Number State | NY
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