Provider Demographics
NPI:1427078484
Name:GELIN, MARIE N (MSW, LMHC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:N
Last Name:GELIN
Suffix:
Gender:F
Credentials:MSW, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BANK ST
Mailing Address - Street 2:FRIST FLOOR
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1005
Mailing Address - Country:US
Mailing Address - Phone:516-503-1571
Mailing Address - Fax:516-285-3689
Practice Address - Street 1:79 BANK ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1005
Practice Address - Country:US
Practice Address - Phone:516-503-1571
Practice Address - Fax:516-285-3689
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health