Individual
ELIZABETH S. GILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
415 S POLLARD ST, VINTON, VA 24179-2502
(540) 977-1102
(540) 344-5343
Mailing address
108 LACEY LN, TROUTVILLE, VA 24175-6568
(540) 977-1102
(540) 344-5343
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0717000328
VA
101YP2500X
Professional Counselor
0701001023
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023943
ANTHEM
VA
01
—
034899
VALUE
VA
01
—
436546
ANTHEM HEALTHKEEPERS
VA
Enumeration date
08/28/2006
Last updated
09/11/2025
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