Provider Demographics
NPI:1922085109
Name:GILCHRIST, PATRICIA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEE
Last Name:GILCHRIST
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 1:13294 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-4301
Mailing Address - Country:US
Mailing Address - Phone:941-276-5096
Mailing Address - Fax:941-698-1045
Practice Address - Street 1:13294 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-4301
Practice Address - Country:US
Practice Address - Phone:941-276-5096
Practice Address - Fax:941-698-1045
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW44041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical