Provider Demographics
NPI:1801033378
Name:GENTLE, ALBERT EUGENE JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:EUGENE
Last Name:GENTLE
Suffix:JR
Gender:M
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:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:TRURO
Mailing Address - State:MA
Mailing Address - Zip Code:02666-0301
Mailing Address - Country:US
Mailing Address - Phone:805-729-5007
Mailing Address - Fax:
Practice Address - Street 1:6 WARREN PL
Practice Address - Street 2:
Practice Address - City:TRURO
Practice Address - State:MA
Practice Address - Zip Code:02666-0301
Practice Address - Country:US
Practice Address - Phone:805-729-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 201011041C0700X
MA1024771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical