Healthcare Provider Details

I. General information

NPI: 1750057089
Provider Name (Legal Business Name): SCOTT THOMAS GILCHRIST LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 SARAZEN LN
CHESTER VA
23836-8628
US

IV. Provider business mailing address

12324 WINDSOR RD
CHESTER VA
23831-4257
US

V. Phone/Fax

Practice location:
  • Phone: 804-691-7917
  • Fax:
Mailing address:
  • Phone: 804-691-7917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904013195
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: