Provider Demographics
NPI:1316022528
Name:GERAGHTY, MICHAEL FRANCIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:GERAGHTY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10968
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-0968
Mailing Address - Country:US
Mailing Address - Phone:239-261-3756
Mailing Address - Fax:239-598-5233
Practice Address - Street 1:5051 CASTELLO DR
Practice Address - Street 2:SUITE 240
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8982
Practice Address - Country:US
Practice Address - Phone:239-261-3756
Practice Address - Fax:239-598-5233
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X, 103TF0000X
FLPY 4604103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59380Medicare UPIN