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General NPI Number Information
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NPI Number | 1184791733
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Entity Type | Individual
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Provider Name | GAIL M LESURE CADAC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 333 EAST ST BRIEN CENTER
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City | PITTSFIELD
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State | MA
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Zip | 01201-5312
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Country | US
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Telephone | 413-499-0412
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Fax | 413-499-0979
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Provider Business Mailing Address
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Address Line | 37 E QUINCY ST
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City | NORTH ADAMS
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State | MA
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Zip | 01247-4307
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Country | US
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Telephone | 413-663-6208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1246 AD
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7301
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License Number State | MA
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