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NPI Code Detail

MEDICARE: GALE LOGAN-MULLINGS LMSW, CCM

MEDICARE: GALE LOGAN-MULLINGS LMSW, CCM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker059568-1NY

General Provider Information

NPI Number : 1114355534
Entity Type Code : Individual
Provider Name (Legal Business Name) : GALE LOGAN-MULLINGS LMSW, CCM
Provider Business Mailing Address
First Line : 1623 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1209
Country : US
Telephone Number : 718-375-1200
Fax Number :
Provider Business Practice Location Address
First Line : 1623 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1209
Country : US
Telephone Number : 718-375-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2013
Last Update Date : 12/28/2025

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