Provider Demographics
NPI:1235214453
Name:GILBERT, NANCY (LMSW, LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LMSW, LPC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LEE
Other - Last Name:BOURDAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1819 GULL RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1611
Mailing Address - Country:US
Mailing Address - Phone:269-381-9800
Mailing Address - Fax:269-381-2932
Practice Address - Street 1:1819 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1611
Practice Address - Country:US
Practice Address - Phone:269-381-9800
Practice Address - Fax:269-381-2932
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009490101Y00000X
MI6801021198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker