Provider Demographics
NPI:1821631193
Name:GILBERT, INGRID C (LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:C
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6903 PROVIDENCE LN W
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-7751
Mailing Address - Country:US
Mailing Address - Phone:704-430-8776
Mailing Address - Fax:
Practice Address - Street 1:6903 PROVIDENCE LN W
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-7751
Practice Address - Country:US
Practice Address - Phone:704-430-8776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14875101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health