Provider Demographics
NPI:1699960237
Name:GERBER, JARED DANIEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:DANIEL
Last Name:GERBER
Suffix:
Gender:M
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:PO BOX 654
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-0654
Mailing Address - Country:US
Mailing Address - Phone:808-429-3678
Mailing Address - Fax:
Practice Address - Street 1:68-051 AKULE ST APT 206
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9405
Practice Address - Country:US
Practice Address - Phone:808-429-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3139101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health