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General NPI Number Information
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NPI Number | 1215296645
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Entity Type | Individual
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Provider Name | LAMAR GILMORE LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 119-29(A) 80TH ROAD
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 347-645-4690
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Fax | 718-263-1811
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Provider Business Mailing Address
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Address Line | 145-42 226TH STREET
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City | SPRINGFIELD GARDENS
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State | NY
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Zip | 11413-3534
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Country | US
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Telephone | 347-645-4690
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Fax | 718-527-7276
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R051640-1
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License Number State | NY
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