Provider Demographics
NPI:1710998653
Name:GITCHELL, M. ANDREE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:M.
Middle Name:ANDREE
Last Name:GITCHELL
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 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-5636
Mailing Address - Fax:540-433-4123
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040018011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008913391Medicaid
VA11526159OtherCAQH
VA1164637518OtherGROUP NPI NUMBER
VA522424OtherVALUE OPTIONS PROVIDER NO
VA187877OtherCOMPSYCH PROVIDER NUMBER
VA086378OtherSENTARA PROVIDER NUMBER
VA2024806OtherCIGNA PROVIDER NUMBER
VA324257OtherANTHEM PROVIDER NUMBER
VA404225OtherTRICARE
VAC05754OtherMEDICARE GROUP NUMBER
VA1164637518OtherGROUP NPI NUMBER
VA800002491Medicare ID - Type UnspecifiedPROVIDER NUMBER