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General NPI Number Information
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NPI Number | 1790678522
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Entity Type | Individual
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Provider Name | JOHN PATRICK GILLESPIE LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 719 SAWDUST RD STE 210
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City | SPRING
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State | TX
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Zip | 77380-2947
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Country | US
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Telephone | 346-202-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 17920 NONESUCH RD
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City | CONROE
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State | TX
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Zip | 77306-8338
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Country | US
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Telephone | 240-538-6795
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Fax |
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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 | 104238
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License Number State | TX
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