Provider Demographics
NPI:1194039438
Name:BERKOWITZ, GERALD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14737 38TH AVE
Mailing Address - Street 2:APT C66
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4803
Mailing Address - Country:US
Mailing Address - Phone:718-762-8275
Mailing Address - Fax:
Practice Address - Street 1:14737 38TH AVE
Practice Address - Street 2:APT C66
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4803
Practice Address - Country:US
Practice Address - Phone:718-762-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP017611-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical