Provider Demographics
NPI:1750315990
Name:GILMER, JANICE F (LICSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:F
Last Name:GILMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SANDHILL DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3243
Mailing Address - Country:US
Mailing Address - Phone:603-424-9696
Mailing Address - Fax:
Practice Address - Street 1:579 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-3407
Practice Address - Country:US
Practice Address - Phone:603-262-9380
Practice Address - Fax:603-262-9381
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30426650Medicaid