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General NPI Number Information
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NPI Number | 1093986853
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Entity Type | Individual
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Provider Name | GERARD ADAM KRUSE LMSW
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Gender | Male
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1400 N SEMORAN BLVD SUITE E
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City | ORLANDO
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State | FL
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Zip | 32807-3536
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Country | US
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Telephone | 917-301-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 17337 CHEVEYO CV
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City | COLLEGE STATION
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State | TX
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Zip | 77845-7461
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Country | US
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Telephone | 501-470-8445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW.09927314
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09927314
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License Number State | CO
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