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NPI Code Detail

MEDICARE: MS. JACQUELYN CAROL GILROY MA, LMHC

MEDICARE: MS. JACQUELYN CAROL GILROY MA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH00003803WA

General Provider Information

NPI Number : 1073667515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELYN CAROL GILROY MA, LMHC
Provider Business Mailing Address
First Line : 4425 FREMONT AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-7225
Country : US
Telephone Number : 206-795-9203
Fax Number :
Provider Business Practice Location Address
First Line : 4425 FREMONT AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-7225
Country : US
Telephone Number : 206-795-9203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 07/08/2007

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