MEDICARE: KRISTINA GILBERT LPC

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
1	101YM0800X	Mental Health Counselor	0701004939	VA

General Provider Information

NPI Number	:	1104161785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA GILBERT LPC

Provider Business Mailing Address
First Line	:	2002 BREMO RD
Second Line	:	SUITE 204
City	:	RICHMOND
State	:	VA
Zip	:	23226-2400
Country	:	US
Telephone Number	:	703-330-9933
Fax Number	:	703-368-8454

Provider Business Practice Location Address
First Line	:	2002 BREMO RD
Second Line	:	SUITE 204
City	:	RICHMOND
State	:	VA
Zip	:	23226-2400
Country	:	US
Telephone Number	:	703-330-9933
Fax Number	:	703-368-8454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	12/07/2012

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Directions to “ KRISTINA GILBERT LPC” Practice Location

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