Provider Demographics
NPI:1881733442
Name:WALKER GERBETZ, NANCY J (LISW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:WALKER GERBETZ
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3869 DARROW RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2691
Mailing Address - Country:US
Mailing Address - Phone:330-686-2748
Mailing Address - Fax:330-686-2784
Practice Address - Street 1:3869 DARROW RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2691
Practice Address - Country:US
Practice Address - Phone:330-686-2748
Practice Address - Fax:330-686-2784
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-1851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW02821Medicare ID - Type UnspecifiedSOCIAL WORKER