Provider Demographics
NPI:1528720687
Name:GAMELSKY, EMMA ASHTON (MSW)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:ASHTON
Last Name:GAMELSKY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 AVENIDA LAS CAMPANAS NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3204
Mailing Address - Country:US
Mailing Address - Phone:505-480-0365
Mailing Address - Fax:
Practice Address - Street 1:833 LOMAS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1955
Practice Address - Country:US
Practice Address - Phone:505-595-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM12077104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker