Doctor Name: | MR. MICHAEL RICHARD GILDEA |
NPI Number: | 1154407450 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, CAC |
License Number: | PC002983 |
Business Practice Address: | 88 N Bull Run Xing Suite 6 Lewisburg, PA - 178376725 |
Business Phone Number: | 5705228330 |
Business Fax Number: | |
Mailing Address: | 88 N Bull Run Xing, Suite 6 LEWISBURG |
State: | PA |
Postal Code: | 178376725 |
Phone Number: | 5705228330 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | PC002983 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |