MEDICARE: MS. ANGELA DENISE GILCHRIST BS

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

General Provider Information

NPI Number	:	1649380841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA DENISE GILCHRIST BS

Provider Business Mailing Address
First Line	:	1547 PARKWAY
Second Line	:	SUITE 100
City	:	GREENWOOD
State	:	SC
Zip	:	29646
Country	:	US
Telephone Number	:	864-229-7120
Fax Number	:	864-229-5526

Provider Business Practice Location Address
First Line	:	202 HIGHWAY 28 NORTH
Second Line	:
City	:	MC CORMICK
State	:	SC
Zip	:	29835-1556
Country	:	US
Telephone Number	:	864-465-2412
Fax Number	:	864-465-3325

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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