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NPI Code Detail

MEDICARE: MS. KAREN REYNOLDS GILL LCSW, CT

MEDICARE: MS. KAREN REYNOLDS GILL LCSW, CT
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
11041C0700XClinical Social Worker0904004537VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111526152OTHERVACAQH

General Provider Information

NPI Number : 1558651836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN REYNOLDS GILL LCSW, CT
Provider Business Mailing Address
First Line : 4210 CREIGHTON RD
Second Line :
City : RICHMOND
State : VA
Zip : 23223-2250
Country : US
Telephone Number : 804-909-0123
Fax Number :
Provider Business Practice Location Address
First Line : 2025 E MAIN ST STE 200
Second Line :
City : RICHMOND
State : VA
Zip : 23223-7073
Country : US
Telephone Number : 804-909-0123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2011
Last Update Date : 08/27/2024

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