Provider Demographics
NPI:1033457981
Name:SWEET, GERALD (PHD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:SWEET
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6264
Mailing Address - Country:US
Mailing Address - Phone:310-463-4061
Mailing Address - Fax:
Practice Address - Street 1:475 FRANKLIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6264
Practice Address - Country:US
Practice Address - Phone:310-463-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1873103TC0700X, 103TF0200X
CA6350103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic