Provider Demographics
NPI:1114266418
Name:GILREATH, CHOEY (LPC-A,)
Entity Type:Individual
Prefix:MS
First Name:CHOEY
Middle Name:
Last Name:GILREATH
Suffix:
Gender:F
Credentials:LPC-A,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 N CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4334
Mailing Address - Country:US
Mailing Address - Phone:336-724-2795
Mailing Address - Fax:336-725-7638
Practice Address - Street 1:491 N CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4334
Practice Address - Country:US
Practice Address - Phone:336-724-2795
Practice Address - Fax:336-725-7638
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9915101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional