Provider Demographics
NPI:1710124284
Name:ABRAMS, GERRYL SUSAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:GERRYL
Middle Name:SUSAN
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 CORAL RIDGE DR
Mailing Address - Street 2:#132
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5433
Mailing Address - Country:US
Mailing Address - Phone:954-609-9350
Mailing Address - Fax:954-721-0524
Practice Address - Street 1:1440 CORAL RIDGE DR
Practice Address - Street 2:#132
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5433
Practice Address - Country:US
Practice Address - Phone:954-609-9350
Practice Address - Fax:954-721-0524
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1049101YM0800X
FLSW3831041C0700X
FLMT852106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist