Provider Demographics
NPI:1235239294
Name:GILLISPIE, DANA GRASSO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:GRASSO
Last Name:GILLISPIE
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 1:600 ROUND ROCK WEST DR
Mailing Address - Street 2:SUITE 606
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5007
Mailing Address - Country:US
Mailing Address - Phone:512-238-6270
Mailing Address - Fax:512-671-9415
Practice Address - Street 1:600 ROUND ROCK WEST DR
Practice Address - Street 2:SUITE 606
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5007
Practice Address - Country:US
Practice Address - Phone:512-238-6270
Practice Address - Fax:512-671-9415
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical