Provider Demographics
NPI:1801157508
Name:GALLINA, NANCY LEE (LCSW)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:GALLINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 E CARVER ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7608
Mailing Address - Country:US
Mailing Address - Phone:516-503-2200
Mailing Address - Fax:
Practice Address - Street 1:49 E CARVER ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7608
Practice Address - Country:US
Practice Address - Phone:516-503-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0755401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical