Provider Demographics
NPI:1376947242
Name:GILBERT, TAMMEY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMEY
Middle Name:
Last Name:GILBERT
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-0160
Mailing Address - Country:US
Mailing Address - Phone:217-357-0617
Mailing Address - Fax:217-357-0615
Practice Address - Street 1:403 S ADAMS ST
Practice Address - Street 2:SUITE 239
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-1624
Practice Address - Country:US
Practice Address - Phone:217-357-0617
Practice Address - Fax:217-357-0615
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490162571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical