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MR. MICHAEL JEROME GILLIARD LPC, NCC
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1598294571
Individual Registrant:MR. MICHAEL JEROME GILLIARD LPC, NCC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
50 AVIATOR PLZ STE 105N ST SIMONS ISLAND, GA 31522-0140 US
Tel: 404-549-6987 Fax: 404-795-5787
Tel: 404-549-6987 Fax: 404-795-5787
Contact information for business:
110 LANTANA CT BRUNSWICK, GA 31520-2211 US
Tel: 843-471-3511 Fax: --
Tel: 843-471-3511 Fax: --
Registration Information:
NPI: 1598294571
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | GA | LPC010398 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
