Provider Demographics
NPI:1235934951
Name:SMITH, GERARD ALBERT (MSW CLINICAL INTERN)
Entity type:Individual
Prefix:MR
First Name:GERARD
Middle Name:ALBERT
Last Name:SMITH
Suffix:
Gender:
Credentials:MSW CLINICAL INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 LOFTUS LN
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2717
Mailing Address - Country:US
Mailing Address - Phone:952-952-6120
Mailing Address - Fax:952-952-6121
Practice Address - Street 1:5725 LOFTUS LN
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2717
Practice Address - Country:US
Practice Address - Phone:952-952-6120
Practice Address - Fax:952-952-6121
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical