Provider Demographics
NPI:1982820429
Name:GERBER, LAURA GILBERT (LCPC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:GILBERT
Last Name:GERBER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 KELBURN RD APT 324
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4385
Mailing Address - Country:US
Mailing Address - Phone:847-933-0051
Mailing Address - Fax:847-933-0057
Practice Address - Street 1:85 REVERE DR STE B
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-8001
Practice Address - Country:US
Practice Address - Phone:847-997-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3000004Medicaid
IL180003770Medicaid