Provider Demographics
NPI:1407734809
Name:GAMBOA, NANCY VICTORIA (LMHC-A)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:VICTORIA
Last Name:GAMBOA
Suffix:
Gender:F
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HOPE ST # 1
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2631
Mailing Address - Country:US
Mailing Address - Phone:401-999-5469
Mailing Address - Fax:
Practice Address - Street 1:8 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2282
Practice Address - Country:US
Practice Address - Phone:774-340-9120
Practice Address - Fax:508-492-2964
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health