Provider Demographics
NPI:1043589583
Name:GEMELARIS, RICHARD ANDREW (MA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ANDREW
Last Name:GEMELARIS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15D LOUDOUN ST SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-2908
Mailing Address - Country:US
Mailing Address - Phone:703-835-7009
Mailing Address - Fax:
Practice Address - Street 1:15D LOUDOUN ST SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2908
Practice Address - Country:US
Practice Address - Phone:703-835-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health