Provider Demographics
NPI:1790727352
Name:QUICK, GAIL M (PH D)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:M
Last Name:QUICK
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MOSSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2801
Mailing Address - Country:US
Mailing Address - Phone:804-677-9673
Mailing Address - Fax:
Practice Address - Street 1:2008 BREMO RD STE 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2443
Practice Address - Country:US
Practice Address - Phone:804-223-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007705182Medicaid
VA175985OtherCOMPSYCH PROVIDER NUMBER
VA110372OtherANTHEM PROVIDER NUMBER
VA80262OtherSENTARA PROVIDER NUMBER
VA254568000OtherMAGELLAN PROVIDER NUMBER