Provider Demographics
NPI:1942352737
Name:POLETTI, GERALYN (LCSW)
Entity Type:Individual
Prefix:
First Name:GERALYN
Middle Name:
Last Name:POLETTI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 HORSESHOE DR S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-6125
Mailing Address - Country:US
Mailing Address - Phone:239-354-1425
Mailing Address - Fax:239-455-6561
Practice Address - Street 1:5025 CASTELLO DR STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8900
Practice Address - Country:US
Practice Address - Phone:239-325-4444
Practice Address - Fax:239-330-7947
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5405171M00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator