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General NPI Number Information
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NPI Number | 1588131007
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Entity Type | Individual
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Provider Name | KATELYN GILL LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 10300 SHORE FRONT PKWY APT 3D
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2774
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Country | US
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Telephone | 845-802-6008
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Fax |
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Provider Business Mailing Address
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Address Line | 357 W OREILLY ST APT 1308
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City | KINGSTON
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State | NY
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Zip | 12401-5731
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Country | US
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Telephone | 347-752-1039
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P10763
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License Number State | NY
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