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General NPI Number Information
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NPI Number | 1871517243
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH GILLESPIE PH.D., LMFT, LPC
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 1619 MONROE ST INTEGRAL PSYCHOLOGY CENTER
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City | MADISON
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State | WI
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Zip | 53711-2063
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Country | US
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Telephone | 608-255-9330
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Fax | 608-255-7810
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Provider Business Mailing Address
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Address Line | 1619 MONROE ST
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City | MADISON
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State | WI
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Zip | 53711-2063
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Country | US
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Telephone | 608-255-9330
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Fax | 608-255-7810
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6390
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4633-125
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000622
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FI00162200
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 880-124
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License Number State | WI
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