Provider Demographics
NPI:1245743004
Name:GERSTMAN, DANIELLE SARA (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SARA
Last Name:GERSTMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:DANI
Other - Middle Name:SARA
Other - Last Name:GERSTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:205 RICHDALE AVE APT A21
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3348
Mailing Address - Country:US
Mailing Address - Phone:954-536-7331
Mailing Address - Fax:
Practice Address - Street 1:401 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2516
Practice Address - Country:US
Practice Address - Phone:339-368-7696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health