Provider Demographics
NPI:1023039880
Name:TREACY, GERARD CHRISTOPHER (MSW)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:CHRISTOPHER
Last Name:TREACY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 LARCHMONT ACRES APT B
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-7332
Mailing Address - Country:US
Mailing Address - Phone:914-682-6952
Mailing Address - Fax:914-682-6955
Practice Address - Street 1:200 BLOOMINGDALE RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1514
Practice Address - Country:US
Practice Address - Phone:914-565-9617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060759-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical