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Individual

GERARD BENEDICT JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
401 NE 4TH ST, FT LAUDERDALE, FL 33301-1151
(954) 453-6400
(954) 764-6458
Mailing address
401 NE 4TH ST, FT LAUDERDALE, FL 33301-1151
(954) 453-6400
(954) 764-6458

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SW10195
FL
171M00000X
Case Manager/Care Coordinator
Primary
SW10195

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003762400
FL
Enumeration date
06/22/2011
Last updated
07/24/2013
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