Individual
AMANDA GERVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
611 LAFAYETTE BLVD, LONG BEACH, NY 11561-1825
(516) 458-8038
Mailing address
611 LAFAYETTE BLVD, LONG BEACH, NY 11561-1825
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
093032
NY
1041C0700X
Clinical Social Worker
Primary
086886
NY
Other
Enumeration date
08/25/2017
Last updated
02/18/2026
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