Provider Demographics
NPI:1821261348
Name:GILBERT, ALBERT ALAN (BS)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:ALAN
Last Name:GILBERT
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GLENDALE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3231
Mailing Address - Country:US
Mailing Address - Phone:313-868-0721
Mailing Address - Fax:313-868-0306
Practice Address - Street 1:211 GLENDALE ST
Practice Address - Street 2:STE 100
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3231
Practice Address - Country:US
Practice Address - Phone:313-868-0721
Practice Address - Fax:313-868-0306
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)