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General NPI Number Information
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NPI Number | 1487585600
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Entity Type | Individual
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Provider Name | ABIGAIL GRACE GILLIS LCSWA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 9121 ANSON WAY STE 254
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City | RALEIGH
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State | NC
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Zip | 27615-3363
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Country | US
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Telephone | 704-832-2200
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Fax | 704-838-1541
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Provider Business Mailing Address
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Address Line | 500 LAUREL SPRINGS DR APT 515
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City | DURHAM
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State | NC
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Zip | 27713-6719
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Country | US
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Telephone | 910-624-7780
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Fax | 704-872-5103
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021640
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License Number State | NC
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