Provider Demographics
NPI:1306859251
Name:GERBER, DOUGLAS K (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:K
Last Name:GERBER
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 1:865 WEST END AVE
Mailing Address - Street 2:#1C
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8402
Mailing Address - Country:US
Mailing Address - Phone:212-866-5782
Mailing Address - Fax:212-932-0340
Practice Address - Street 1:865 WEST END AVE
Practice Address - Street 2:#1C
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10025-8402
Practice Address - Country:US
Practice Address - Phone:212-866-5782
Practice Address - Fax:212-932-0340
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0226431104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker