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General NPI Number Information
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NPI Number | 1780937987
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Entity Type | Individual
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Provider Name | DONALD R GATWOOD LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 611 E MAIN ST STE 110
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City | PETERSBURG
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State | IN
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Zip | 47567-1270
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Country | US
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Telephone | 812-354-8785
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Fax | 812-354-8786
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Provider Business Mailing Address
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Address Line | PO BOX 556
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City | VINCENNES
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State | IN
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Zip | 47591-0556
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Country | US
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Telephone | 812-494-9501
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Fax | 812-494-9502
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34001564A
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License Number State | IN
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