Provider Demographics
NPI:1215277975
Name:MASCALI, GINA (CASAC,CADC,BA)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:MASCALI
Suffix:
Gender:F
Credentials:CASAC,CADC,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DUTCH VLG
Mailing Address - Street 2:APT 2B
Mailing Address - City:MENANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12204-2920
Mailing Address - Country:US
Mailing Address - Phone:518-225-9821
Mailing Address - Fax:
Practice Address - Street 1:845 CENTRAL AVE
Practice Address - Street 2:SOUTH 3
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1514
Practice Address - Country:US
Practice Address - Phone:518-482-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21787101YA0400X
MA1531AD101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)