Basic Information
| Provider Information | |||||||||
| NPI: | 1821197419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PETERS | ||||||||
| FirstName: | GILBERT | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 71 H STREET | ||||||||
| Address2: | |||||||||
| City: | HULL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819251875 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1261 FURNACE BROOK PARKWAY | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174794545 | ||||||||
| FaxNumber: | 6174794555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| 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 | 104100000X | 5376 | MA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.