Provider Demographics
NPI:1265008460
Name:GILMORE, TOREY JAMOL (LPC-ASSOCIATE, NCC)
Entity Type:Individual
Prefix:MR
First Name:TOREY
Middle Name:JAMOL
Last Name:GILMORE
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 WINDY PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77423-3534
Mailing Address - Country:US
Mailing Address - Phone:832-613-4798
Mailing Address - Fax:
Practice Address - Street 1:5119 WINDY PLANTATION DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77423-3534
Practice Address - Country:US
Practice Address - Phone:832-613-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13123150OtherTEXAS DRIVERS LICENSE