Provider Demographics
NPI:1669744066
Name:GERSON, BARBARA FRANCINE (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:FRANCINE
Last Name:GERSON
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 1:14041 ICOT BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3702
Mailing Address - Country:US
Mailing Address - Phone:727-479-1800
Mailing Address - Fax:727-479-1248
Practice Address - Street 1:14041 ICOT BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3702
Practice Address - Country:US
Practice Address - Phone:727-479-1800
Practice Address - Fax:727-479-1248
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW71971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW7197OtherSTATE OF FLORIDA - DEPT OF HEALTH
FL004498200Medicaid
FLSW7197OtherSTATE OF FLORIDA - DEPT OF HEALTH