Provider Demographics
NPI:1548327836
Name:GERBER, MADELEINE SANDRA (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:MADELEINE
Middle Name:SANDRA
Last Name:GERBER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 SOUTH ADELAIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1605
Mailing Address - Country:US
Mailing Address - Phone:732-247-1819
Mailing Address - Fax:732-247-1819
Practice Address - Street 1:261 SOUTH ADELAIDE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1605
Practice Address - Country:US
Practice Address - Phone:732-247-1819
Practice Address - Fax:732-247-1819
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001586001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GE706333Medicare ID - Type Unspecified