Provider Demographics
NPI:1407066269
Name:GERSON, SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:GERSON
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 1:12 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2011
Mailing Address - Country:US
Mailing Address - Phone:973-768-3002
Mailing Address - Fax:
Practice Address - Street 1:12 WARNER RD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2011
Practice Address - Country:US
Practice Address - Phone:739-768-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052116001041C0700X
NJ44SCO52116001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical