Provider Demographics
NPI:1255439709
Name:GERARD ASSOCIATES INC
Entity type:Organization
Organization Name:GERARD ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW DCSW
Authorized Official - Phone:260-422-9372
Mailing Address - Street 1:4656 W JEFFERSON BLVD
Mailing Address - Street 2:SUITE 285
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804
Mailing Address - Country:US
Mailing Address - Phone:260-422-9372
Mailing Address - Fax:260-422-0843
Practice Address - Street 1:4656 W JEFFERSON BLVD
Practice Address - Street 2:SUITE 285
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804
Practice Address - Country:US
Practice Address - Phone:260-422-9372
Practice Address - Fax:260-422-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001586A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN280469OtherVALUE OPTIONS
IN000000143197OtherANTHEM
IN4405318OtherAETNA
IN280469OtherVALUE OPTIONS