Provider Demographics
NPI:1235149394
Name:GILL, VALERIE ANN (MSW)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ANN
Last Name:GILL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-9533
Mailing Address - Country:US
Mailing Address - Phone:608-568-7511
Mailing Address - Fax:608-348-4191
Practice Address - Street 1:1250 E HWY 151 SUITE D
Practice Address - Street 2:BOX 36
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818
Practice Address - Country:US
Practice Address - Phone:608-348-4060
Practice Address - Fax:608-348-4191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI126721121101YM0800X
IA06482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40992200Medicaid
WI42190100Medicaid