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NPI 1184919839

NPI 1184919839 : ANDREW GILL LPC-S, LCDC : IRVING, TX

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General NPI Number Information
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    NPI Number           |    1184919839
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW GILL LPC-S, LCDC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/10/2011
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    Last Update Date     |    01/08/2025
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Provider Practice Location Address
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    Address Line         |    1304 W WALNUT HILL LN STE 120 
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    City                 |    IRVING
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    State                |    TX
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    Zip                  |    75038-3002
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    Country              |    US
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    Telephone            |    817-360-5364
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    Fax                  |    817-977-8303
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Provider Business Mailing Address
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    Address Line         |    1304 W WALNUT HILL LN STE 120 
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    City                 |    IRVING
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    State                |    TX
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    Zip                  |    75038-3002
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    Country              |    US
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    Telephone            |    817-360-5364
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    Fax                  |    817-977-8303
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    10377
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    62128
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    License Number State |    TX
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