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NPI Code Detail

MEDICARE: THOMAS EDWARD GILLESPIE MSW CSSW

MEDICARE: THOMAS EDWARD GILLESPIE MSW CSSW
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
11041S0200XSchool Social WorkerPPS-516438VA

General Provider Information

NPI Number : 1710478938
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS EDWARD GILLESPIE MSW CSSW
Provider Business Mailing Address
First Line : 4508 REEDY AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23225-4639
Country : US
Telephone Number : 804-241-1948
Fax Number :
Provider Business Practice Location Address
First Line : 119 W LEIGH ST
Second Line :
City : RICHMOND
State : VA
Zip : 23220-3210
Country : US
Telephone Number : 804-780-7850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2018
Last Update Date : 05/23/2018

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