Provider Demographics
NPI:1407464126
Name:GILLESPIE, BRENDA JOYCE HINSON (LMSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:JOYCE HINSON
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 JOSEPH E LOWERY BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-3421
Mailing Address - Country:US
Mailing Address - Phone:404-853-2859
Mailing Address - Fax:404-853-2884
Practice Address - Street 1:80 JOSEPH E LOWERY BLVD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-3421
Practice Address - Country:US
Practice Address - Phone:404-853-2859
Practice Address - Fax:404-853-2884
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0038741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMSW003874OtherLMSW NUMBER