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Individual
JAMES MICAH GERRITSEN
Active
Individual
JAMES MICAH GERRITSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11813011-3502
UT
1041C0700X
Clinical Social Worker
Primary
11813011-3501
UT
Other
Enumeration date
09/23/2020
Last updated
10/14/2026
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