Provider Demographics
NPI:1336288620
Name:GILMORE-CRONIN, JOHN EDWARD (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:GILMORE-CRONIN
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Gender:M
Credentials:LPC
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Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:943 W ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2516
Practice Address - Country:US
Practice Address - Phone:252-433-0061
Practice Address - Fax:252-433-0065
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NC6439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103559Medicaid