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General NPI Number Information
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NPI Number | 1629344080
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Entity Type | Individual
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Provider Name | GERARD GALTON VANSLUYTMAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 91 GUY LOMBARDO AVENUE
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City | FREEPORT
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State | NY
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Zip | 11520
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Country | US
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Telephone | 516-868-3033
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Fax |
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Provider Business Mailing Address
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Address Line | 1867 BROWNING STREET
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City | BALDWIN
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State | NY
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Zip | 11510
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Country | US
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Telephone | 917-207-2075
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 072388
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 093402
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License Number State | NY
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