Individual
ALEX GERRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LICSW
Contact information
Practice address
3464 WASHINGTON ST, JAMAICA PLAIN, MA 02130-2665
(781) 561-0205
Mailing address
3464 WASHINGTON ST, JAMAICA PLAIN, MA 02130-2665
(781) 561-0205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
221989
MA
1041C0700X
Clinical Social Worker
Primary
121740
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110149004A
—
MA
Enumeration date
11/10/2016
Last updated
12/11/2024
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