MEDICARE: MS. JESSICA GERSON LCSW, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3940	NH
2	1041C0700X	Clinical Social Worker	LICSW123817	MA
3	1041C0700X	Clinical Social Worker	11545	LA

General Provider Information

NPI Number	:	1538425491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA GERSON LCSW, LICSW

Provider Business Mailing Address
First Line	:	PO BOX 28035 RPO WESTSHORE
Second Line	:
City	:	VICTORIA
State	:	BRITISH COLUMBIA
Zip	:	V9B 6K8
Country	:	CA
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 POYDRAS ST STE 102
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-6015
Country	:	US
Telephone Number	:	555-555-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2012
Last Update Date	:	03/10/2026

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