Provider Demographics
NPI:1871860981
Name:GILMOUR, DOUGLAS S
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:S
Last Name:GILMOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 ROUTE 55 ROOM 2114
Mailing Address - Street 2:ARLINGTON H.S.
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540
Mailing Address - Country:US
Mailing Address - Phone:845-486-4860
Mailing Address - Fax:
Practice Address - Street 1:1157 ROUTE 55 ROOM 2114
Practice Address - Street 2:ARLINGTON H.S.
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540
Practice Address - Country:US
Practice Address - Phone:845-486-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036576-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool