Provider Demographics
NPI:1093844490
Name:GILLELAND, JAMES DREW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DREW
Last Name:GILLELAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6290 ABBOTTS BRIDGE RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8495
Mailing Address - Country:US
Mailing Address - Phone:770-929-6263
Mailing Address - Fax:770-623-8846
Practice Address - Street 1:6290 ABBOTTS BRIDGE RD
Practice Address - Street 2:SUITE 502
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8495
Practice Address - Country:US
Practice Address - Phone:770-929-6263
Practice Address - Fax:770-623-8846
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0013571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical