Provider Demographics
NPI:1619770039
Name:MACKRITIS, GERALYN (LCSW)
Entity type:Individual
Prefix:
First Name:GERALYN
Middle Name:
Last Name:MACKRITIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GERALYN
Other - Middle Name:
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5206 NW 57TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-3320
Mailing Address - Country:US
Mailing Address - Phone:352-681-9435
Mailing Address - Fax:
Practice Address - Street 1:5206 NW 57TH LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-3320
Practice Address - Country:US
Practice Address - Phone:352-681-9435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW63941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty