Provider Demographics
NPI:1437742186
Name:GILMAN, JODI LYNN (LCMHC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:GILMAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3515
Mailing Address - Country:US
Mailing Address - Phone:508-954-9102
Mailing Address - Fax:
Practice Address - Street 1:68 HOPE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3515
Practice Address - Country:US
Practice Address - Phone:508-954-9102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0077021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health