Provider Demographics
NPI:1659324945
Name:GERSHMAN, JAIME BETH (LICSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:BETH
Last Name:GERSHMAN
Suffix:
Gender:F
Credentials:LICSW
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 372
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-0372
Mailing Address - Country:US
Mailing Address - Phone:860-237-8321
Mailing Address - Fax:
Practice Address - Street 1:2 STRONG AVE
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3923
Practice Address - Country:US
Practice Address - Phone:860-237-8321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0052081041C0700X
MA1139281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical