Provider Demographics
NPI:1538148713
Name:GADOL, LOUIS CARL (PHD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:CARL
Last Name:GADOL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 N TOMS ST
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-2500
Mailing Address - Country:US
Mailing Address - Phone:828-287-8890
Mailing Address - Fax:828-287-3102
Practice Address - Street 1:270 N TOMS ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2500
Practice Address - Country:US
Practice Address - Phone:828-287-8890
Practice Address - Fax:828-287-3102
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1176103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA2827COtherMEDCOST
NC6000049Medicaid
NC0335AOtherBLUE CROSS AND BLUE SHIEL
NCA2827COtherMEDCOST