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NPI Code Detail

MEDICARE: MICHELLE D GILMORE CDCA

MEDICARE: MICHELLE D GILMORE CDCA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor.162779OH
2101YP2500XProfessional CounselorC.2506799OH

General Provider Information

NPI Number : 1679893978
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE D GILMORE CDCA
Provider Business Mailing Address
First Line : 4449 STATE ROUTE 159
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-8620
Country : US
Telephone Number : 740-775-1260
Fax Number :
Provider Business Practice Location Address
First Line : 111 W WATER ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-2452
Country : US
Telephone Number : 740-851-6493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2010
Last Update Date : 10/13/2025

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Directions to “ MICHELLE D GILMORE CDCA” Practice Location

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