Provider Demographics
NPI:1124800750
Name:GONSKI, HAILY SARAH (LCSW-C)
Entity type:Individual
Prefix:
First Name:HAILY
Middle Name:SARAH
Last Name:GONSKI
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13211 LUTES DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3233
Mailing Address - Country:US
Mailing Address - Phone:203-278-4983
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING ST STE 100
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2751
Practice Address - Country:US
Practice Address - Phone:301-572-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical