Provider Demographics
NPI:1073721338
Name:CARDE, GILBERT DARRIN (LMSW)
Entity Type:Individual
Prefix:PROF
First Name:GILBERT
Middle Name:DARRIN
Last Name:CARDE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 HARMON AVE
Mailing Address - Street 2:STE 1D03
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5611
Mailing Address - Country:US
Mailing Address - Phone:912-435-6633
Mailing Address - Fax:616-776-2934
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:STE 1D03
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5611
Practice Address - Country:US
Practice Address - Phone:912-435-6633
Practice Address - Fax:616-776-2934
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010215361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7000020881OtherPRIORITY HEALTH
MI352744000OtherMAGELLAN
MIPVM190358Medicaid
MI80-0-89-5748-0OtherBLUE CROSS-BLUE SHIELD
MI80-0-89-5748-0OtherBLUE CROSS-BLUE SHIELD