MEDICARE: NINA GILBERT PSYCHOTHERAPY, LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1982188835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NINA GILBERT PSYCHOTHERAPY, LLC

Provider Business Mailing Address
First Line	:	14 DORA ST APT 4
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-9407
Country	:	US
Telephone Number	:	704-281-3411
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 DORA ST APT 4
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-9407
Country	:	US
Telephone Number	:	704-281-3411
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	NINA GILBERT
Credential	:	LCSW
Telephone Number	:	704-281-3411

Provider Enumeration Date	:	09/17/2018
Last Update Date	:	12/08/2025

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