Provider Demographics
NPI:1326053711
Name:GILARDI, TAMALA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMALA
Middle Name:KAY
Last Name:GILARDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 EVELYN BYRD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3483
Mailing Address - Country:US
Mailing Address - Phone:540-820-7673
Mailing Address - Fax:540-437-0421
Practice Address - Street 1:1951 EVELYN BYRD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3483
Practice Address - Country:US
Practice Address - Phone:540-820-7673
Practice Address - Fax:540-437-0421
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040057511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010165989Medicaid
VA179044OtherANTHEM
VA085360MOtherSENTARA