Provider Demographics
NPI:1417902651
Name:FLOERSCH, JERALD E (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:JERALD
Middle Name:E
Last Name:FLOERSCH
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:DR
Other - First Name:JERALD
Other - Middle Name:E
Other - Last Name:FLOERSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LCSW
Mailing Address - Street 1:900 MASSACHUSETTS ST STE 408
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-6001
Mailing Address - Country:US
Mailing Address - Phone:216-346-3469
Mailing Address - Fax:
Practice Address - Street 1:900 MASSACHUSETTS ST STE 408
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-6001
Practice Address - Country:US
Practice Address - Phone:216-346-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054551001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical