Provider Demographics
NPI:1871697284
Name:GILMOUR, PATRICIA DIANE (MAED LMFT LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:DIANE
Last Name:GILMOUR
Suffix:
Gender:F
Credentials:MAED LMFT LPC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:DIANE
Other - Last Name:GILMOUR-SYLVESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAED LMFT LPC
Mailing Address - Street 1:200 E NORTHWOOD ST
Mailing Address - Street 2:STE 508
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1214
Mailing Address - Country:US
Mailing Address - Phone:336-275-9889
Mailing Address - Fax:336-275-9880
Practice Address - Street 1:200 E NORTHWOOD ST
Practice Address - Street 2:STE 508
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1214
Practice Address - Country:US
Practice Address - Phone:336-275-9889
Practice Address - Fax:336-275-9880
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC 2924 LMFT 458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102266Medicaid