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JOSEPH MCGILLIS LAC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1972615268

Individual Registrant:
 JOSEPH  MCGILLIS LAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
331 4TH AVE E  TRENTON, ND 58853-9998 US
Tel: 701-774-0461  Fax: 701-774-8003

Contact information for business:
PO BOX 2182  WILLISTON, ND 58802-2182 US
Tel: 701-774-0461  Fax: 701-774-8003

Registration Information:
NPI: 1972615268
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
ND3048

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BC/BS OF ND PROVIDER NUM.26735ND01
1312ND05




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