Provider Demographics
NPI:1912127226
Name:WILHELM, GRETCHEN ELIZABETH (PHD, LPC, LSATP)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:ELIZABETH
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PHD, LPC, LSATP
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:ELIZABETH
Other - Last Name:SQUIRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 N. CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401
Mailing Address - Country:US
Mailing Address - Phone:540-949-7045
Mailing Address - Fax:540-949-8897
Practice Address - Street 1:2 N. CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401
Practice Address - Country:US
Practice Address - Phone:540-949-7045
Practice Address - Fax:540-949-8897
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011159101YA0400X
OHC 0008035101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)