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NPI Code Detail

MEDICARE: KATIE GILLIS

MEDICARE:   KATIE  GILLIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorNJ

General Provider Information

NPI Number : 1689507931
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE GILLIS
Provider Business Mailing Address
First Line : 2 PARK AVE
Second Line :
City : DUMONT
State : NJ
Zip : 07628-3004
Country : US
Telephone Number : 201-567-0059
Fax Number :
Provider Business Practice Location Address
First Line : 2 PARK AVE
Second Line :
City : DUMONT
State : NJ
Zip : 07628-3004
Country : US
Telephone Number : 201-567-0059
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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Directions to “ KATIE GILLIS ” Practice Location

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