Healthcare Provider Details

I. General information

NPI: 1285643387
Provider Name (Legal Business Name): CHRISTINE F GILCHRIST LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 POPLAR HILL RD SUITE B
CHESAPEAKE VA
23321-5531
US

IV. Provider business mailing address

3802 POPLAR HILL RD SUITE B
CHESAPEAKE VA
23321-5531
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-5111
  • Fax: 757-686-4845
Mailing address:
  • Phone: 757-483-5111
  • Fax: 757-686-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001519
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: