MEDICARE: GILL COUNSELING & CONSULTING, LLC

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	1041C0700X	Clinical Social Worker	0904004537	VA

General Provider Information

NPI Number	:	1437441136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILL COUNSELING & CONSULTING, LLC

Provider Business Mailing Address
First Line	:	4210 CREIGHTON RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-2250
Country	:	US
Telephone Number	:	804-909-0123
Fax Number	:	804-343-0004

Provider Business Practice Location Address
First Line	:	2025 E MAIN ST STE 200
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-7073
Country	:	US
Telephone Number	:	804-343-9786
Fax Number	:	804-343-0004

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	MS. KAREN R. GILL
Credential	:	LCSW, CT
Telephone Number	:	804-343-9786

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	08/27/2024

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