Provider Demographics
NPI:1932358587
Name:GEBHARDT, MORGAN KIMBERLY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:KIMBERLY
Last Name:GEBHARDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:MSC 1240
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:718-270-6776
Mailing Address - Fax:718-270-2298
Practice Address - Street 1:470 CLARKSON AVE
Practice Address - Street 2:SUITE J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-6776
Practice Address - Fax:718-270-2298
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCASAC-28869101YA0400X
NY0785861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)