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NPI Code Detail

MEDICARE: SUSAN GILMAN LCSW

MEDICARE: SUSAN GILMAN LCSW
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
11041C0700XClinical Social WorkerLSW0000006975TN
21041C0700XClinical Social Worker0904008709VA

General Provider Information

NPI Number : 1538529292
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN GILMAN LCSW
Provider Business Mailing Address
First Line : 2112 N ROAN ST STE 300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2519
Country : US
Telephone Number : 865-588-3173
Fax Number : 865-244-3579
Provider Business Practice Location Address
First Line : 2112 N ROAN ST STE 300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2519
Country : US
Telephone Number : 865-588-3173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2016
Last Update Date : 01/08/2026

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Directions to “ SUSAN GILMAN LCSW” Practice Location

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