Provider Demographics
NPI:1184828550
Name:GILCHRIST, DONNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
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 1:230 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:SEASIDE HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08751-2313
Mailing Address - Country:US
Mailing Address - Phone:848-448-9152
Mailing Address - Fax:
Practice Address - Street 1:985 PATTON ST
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2272
Practice Address - Country:US
Practice Address - Phone:732-247-9772
Practice Address - Fax:732-247-5799
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048365001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223773222OtherTAX IDENTIFICATION