Provider Demographics
NPI:1336280783
Name:GILSON, VIRGINIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:GILSON
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 1:515 BRATTLEBORO RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01337-9540
Mailing Address - Country:US
Mailing Address - Phone:413-774-5450
Mailing Address - Fax:
Practice Address - Street 1:13 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3506
Practice Address - Country:US
Practice Address - Phone:413-775-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1054361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GI P21248Medicare ID - Type Unspecified
MEPO5877Medicare UPIN