Doctor Name: | MRS. ALISA BETH GUMAER |
NPI Number: | 1518261601 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 080530 |
Business Practice Address: | 2025 Us Route 9w Ravena, NY - 121439000 |
Business Phone Number: | 5187565200 |
Business Fax Number: | |
Mailing Address: | 2025 Route 9w, RAVENA |
State: | NY |
Postal Code: | 121430150 |
Phone Number: | 5187565200 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2011 |
NPI Last Update Date: | 05/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 080530 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |