Healthcare Provider Details

I. General information

NPI: 1063208312
Provider Name (Legal Business Name): GUERLINE GELIN CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EMANCIPATION DR
HAMPTON VA
23667-0001
US

IV. Provider business mailing address

38 W PRESTON ST
HAMPTON VA
23669-2143
US

V. Phone/Fax

Practice location:
  • Phone: 757-315-3488
  • Fax:
Mailing address:
  • Phone: 757-831-0357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW03295
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: