Provider Demographics
NPI:1467678185
Name:GERTLER, NANCIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCIE
Middle Name:
Last Name:GERTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NANCIE
Other - Middle Name:
Other - Last Name:ZIVETZ GERTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1012 SW EMKAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702
Mailing Address - Country:US
Mailing Address - Phone:541-382-3969
Mailing Address - Fax:541-388-5110
Practice Address - Street 1:1012 SW EMKAY DRIVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-382-3969
Practice Address - Fax:541-388-5110
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical