Provider Demographics
NPI:1164231197
Name:SAMUELS, GAYLE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:
Last Name:SAMUELS
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 1:38 JOYCETON WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1327
Mailing Address - Country:US
Mailing Address - Phone:202-744-4090
Mailing Address - Fax:
Practice Address - Street 1:38 JOYCETON WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1327
Practice Address - Country:US
Practice Address - Phone:202-744-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD085671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical