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Individual

MICHAEL LEE GILMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW, ACSW

Contact information

Practice address
2 CHURCH ST, SUITE 4G, BURLINGTON, VT 05401-4299
(802) 651-7681
(802) 658-4888
Mailing address
48 NORTHSHORE DRIVE, BURLINGTON, VT 05408-1250
(802) 651-7681

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000642
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1006827
VT
01
48460
BLUE CROSS BLUE SHIELD
VT
01
610054
MVP
VT
Enumeration date
09/20/2006
Last updated
07/09/2007
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