Provider Demographics
NPI:1962482273
Name:BEDSOLE, GERALD (LICSW)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:BEDSOLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2435
Mailing Address - Country:US
Mailing Address - Phone:781-335-6000
Mailing Address - Fax:
Practice Address - Street 1:49 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2435
Practice Address - Country:US
Practice Address - Phone:781-335-6000
Practice Address - Fax:617-288-3910
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10274501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical