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NPI Code Detail

MEDICARE: KEISHA M GILL LPC

MEDICARE: KEISHA M GILL LPC
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
1101YP2500XProfessional Counselor2013022877MO

General Provider Information

NPI Number : 1568812030
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEISHA M GILL LPC
Provider Business Mailing Address
First Line : 11500 STATE HIGHWAY 121 STE 930
Second Line :
City : FRISCO
State : TX
Zip : 75035-9347
Country : US
Telephone Number : 469-200-4093
Fax Number :
Provider Business Practice Location Address
First Line : 11500 STATE HIGHWAY 121 STE 510
Second Line :
City : FRISCO
State : TX
Zip : 75035-9348
Country : US
Telephone Number : 469-200-4093
Fax Number : 469-200-4079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 11/27/2023

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Directions to “ KEISHA M GILL LPC” Practice Location

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