Provider Demographics
NPI:1841585106
Name:GILL COUNSELING& CONSULTING, LLC
Entity Type:Organization
Organization Name:GILL COUNSELING& CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CT
Authorized Official - Phone:804-343-9786
Mailing Address - Street 1:4210 CREIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-2250
Mailing Address - Country:US
Mailing Address - Phone:804-909-0123
Mailing Address - Fax:804-343-0004
Practice Address - Street 1:3215 ROCK CREEK VILLA DR
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1656
Practice Address - Country:US
Practice Address - Phone:804-343-9786
Practice Address - Fax:804-343-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904004537251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11526152OtherCAQH