Provider Demographics
NPI:1871857524
Name:GEHRKE, CARMEN FARRO (LPC, LPCMH)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:FARRO
Last Name:GEHRKE
Suffix:
Gender:F
Credentials:LPC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 CARAVELLE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8207
Mailing Address - Country:US
Mailing Address - Phone:651-602-0833
Mailing Address - Fax:561-656-2099
Practice Address - Street 1:800 VILLAGE SQUARE XING STE 109
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4540
Practice Address - Country:US
Practice Address - Phone:561-602-0833
Practice Address - Fax:561-656-2099
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006378101YP2500X
DEPC-0000618101YP2500X
FLMH14612101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional