Provider Demographics
NPI:1437381878
Name:BOTTOMLEY, GAIL M (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:M
Last Name:BOTTOMLEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CHELSEA LN APT 7
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-4695
Mailing Address - Country:US
Mailing Address - Phone:304-258-9894
Mailing Address - Fax:
Practice Address - Street 1:45 CHELSEA LN APT 7
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-4695
Practice Address - Country:US
Practice Address - Phone:304-258-9894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2285101YM0800X
MDAD0018101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)