MEDICARE: ANDREW GILL LPC-S, LCDC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	10377	TX
2	101YM0800X	Mental Health Counselor	62128	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184919839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW GILL LPC-S, LCDC

Provider Business Mailing Address
First Line	:	1304 W WALNUT HILL LN STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3002
Country	:	US
Telephone Number	:	817-360-5364
Fax Number	:	817-977-8303

Provider Business Practice Location Address
First Line	:	1304 W WALNUT HILL LN STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3002
Country	:	US
Telephone Number	:	817-360-5364
Fax Number	:	817-977-8303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2011
Last Update Date	:	01/08/2025

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Directions to “ ANDREW GILL LPC-S, LCDC” Practice Location

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