Provider Demographics
NPI:1770231623
Name:GILBERT, ELIZABETH HAMMOND PROCTOR (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HAMMOND PROCTOR
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 1:318 HARPERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-2304
Mailing Address - Country:US
Mailing Address - Phone:757-951-3391
Mailing Address - Fax:
Practice Address - Street 1:100 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-3190
Practice Address - Country:US
Practice Address - Phone:757-736-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
VA09040114321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical