Basic Information
| Provider Information | |||||||||
| NPI: | 1326143934 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEARHART | ||||||||
| FirstName: | CARY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 SACHEM CIR | ||||||||
| Address2: | |||||||||
| City: | PEMBROOK | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812939836 | ||||||||
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| Practice Location | |||||||||
| Address1: | 37 BELMONT ST | ||||||||
| Address2: | SOUTH BAY MENTAL HEALTH CENTER | ||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085804691 | ||||||||
| FaxNumber: | 5085885751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 7361 | MA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.