| Susan Gilman, LCSW | |
|
2112 N Roan St Ste 300, Johnson City, TN 37601-2519 | |
| (865) 588-3173 | |
| Not Available |
| Full Name | Susan Gilman |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 2112 N Roan St Ste 300, Johnson City, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538529292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LSW0000006975 (Tennessee) | Primary |
| 1041C0700X | Social Worker - Clinical | 0904008709 (Virginia) | Secondary |
| Entity Name | Revida Recovery Centers Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013483486 PECOS PAC ID: 1153657473 Enrollment ID: O20190904001928 |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Gilman, LCSW 2112 N Roan St Ste 300, Johnson City, TN 37601-2519 Ph: (865) 588-3173 | Susan Gilman, LCSW 2112 N Roan St Ste 300, Johnson City, TN 37601-2519 Ph: (865) 588-3173 |
Mrs. Krysten Kelch, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 112 E Myrtle Ave Ste 300, Johnson City, TN 37601 Phone: 423-461-0015 | |
Nikita Marie Thompson, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 917 W Walnut St, Johnson City, TN 37604 Phone: 423-439-6464 Fax: 423-439-7118 | |
Deborah Ann Thibeault, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 325 N State Of Franklin Rd, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343 | |
Mr. Jay Richard Shilling, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1416 S Roan St, Oaks Castle Clinic, Johnson City, TN 37601 Phone: 423-979-6257 | |
Amy Michelle Roberts, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 1211 King Springs Rd Apt 606, Johnson City, TN 37601 Phone: 423-946-4938 | |
Benton W Ashe, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 W Watauga Ave, Johnson City, TN 37604 Phone: 423-232-2600 Fax: 423-232-2616 | |
Sarah Mccray, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2112 N Roan St Ste 300, Johnson City, TN 37601 Phone: 865-588-3173 Fax: 865-244-3579 |