Provider Demographics
NPI:1114173812
Name:WASHKO, GERALD J (LMFT, LCADC)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:J
Last Name:WASHKO
Suffix:
Gender:M
Credentials:LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 EAST BARBER AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2832
Mailing Address - Country:US
Mailing Address - Phone:856-845-6944
Mailing Address - Fax:856-845-6944
Practice Address - Street 1:439 EAST BARBER AVENUE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-2832
Practice Address - Country:US
Practice Address - Phone:856-845-6944
Practice Address - Fax:856-845-6944
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100156600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist