Provider Demographics
NPI:1407961428
Name:GILL, HEATHER CUTLER (LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CUTLER
Last Name:GILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WOODRUFF RD
Mailing Address - Street 2:BUILDING A-3
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5730
Mailing Address - Country:US
Mailing Address - Phone:864-678-4725
Mailing Address - Fax:864-676-9432
Practice Address - Street 1:1200 WOODRUFF RD
Practice Address - Street 2:BUILDING A-3
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5730
Practice Address - Country:US
Practice Address - Phone:864-678-4725
Practice Address - Fax:864-288-7937
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4725OtherLPC LICENSE