Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gina Marie Divincenzo, LCSW

Individual provider Clinical Social Worker · NPI 1912066416

Gina Marie Divincenzo, LCSW is a Clinical Social Worker in Syosset, New York. Qualified in 1998, 28 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
28
Licensed in
NY
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

175 Jericho Tpke Ste 213
Syosset, NY 11791-4501
Phone: (631) 316-3965
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence PR058073-1 (NY)

Record details

NPI number1912066416
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 8, 2006
Last updated in NPPESSeptember 1, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Syosset