Provider Demographics
NPI:1114436300
Name:GILL, ANNE DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:DENISE
Last Name:GILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 W SLEEPY RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8066
Mailing Address - Country:US
Mailing Address - Phone:623-444-8227
Mailing Address - Fax:
Practice Address - Street 1:1637 W SLEEPY RANCH RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8066
Practice Address - Country:US
Practice Address - Phone:623-888-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-122931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical