Provider Demographics
NPI:1265577480
Name:GERDT, AUDREY (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:
Last Name:GERDT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:HENKELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2809 WISCONSIN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2955
Mailing Address - Country:US
Mailing Address - Phone:708-207-7967
Mailing Address - Fax:
Practice Address - Street 1:1100 LAKE ST
Practice Address - Street 2:SUITE 210C
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1015
Practice Address - Country:US
Practice Address - Phone:708-207-7967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker