| Organization Name: | GMC LCSW LLC |
| NPI Number: | 1164774279 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GINA M. CONSTANTINI (THERAPIST) |
| Mailing Address: | 241 Main St B Blakely |
| State: | PA US |
| Postal Code: | 184471233 |
| Phone Number: | 5709473163 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 11/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CW015803 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |