Provider Demographics
NPI:1285920207
Name:GILB, ELIZABETH M (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:GILB
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 ROAD 8 1/2
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-8509
Mailing Address - Country:US
Mailing Address - Phone:307-271-2685
Mailing Address - Fax:
Practice Address - Street 1:253 E 2ND ST
Practice Address - Street 2:STE 1
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-1900
Practice Address - Country:US
Practice Address - Phone:307-271-2685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYWY758171M00000X
WY758172V00000X, 1041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health