Provider Demographics
NPI:1912113697
Name:GILBERT, A BETHEL (LICSW)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:BETHEL
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 PINE CONE STRAND
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01718-1010
Mailing Address - Country:US
Mailing Address - Phone:978-263-3775
Mailing Address - Fax:
Practice Address - Street 1:518 GREAT ROAD
Practice Address - Street 2:BOUNDARIES THERAPY CENTER
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3415
Practice Address - Country:US
Practice Address - Phone:978-263-4878
Practice Address - Fax:978-635-0386
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical