MEDICARE: MR. JOHN EDWARD GILMORE-CRONIN 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	101YP2500X	Professional Counselor	6439	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336288620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN EDWARD GILMORE-CRONIN LPC

Provider Business Mailing Address
First Line	:	284 EXECUTIVE PARK DR STE 100
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-1833
Country	:	US
Telephone Number	:	704-939-1100
Fax Number	:	704-939-1173

Provider Business Practice Location Address
First Line	:	943 W ANDREWS AVE
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-2516
Country	:	US
Telephone Number	:	252-433-0061
Fax Number	:	252-433-0065

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/21/2022

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