Provider Demographics
NPI:1447782156
Name:GLEESON, JOHN CURT (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CURT
Last Name:GLEESON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OLD LYNCHBURG RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6500
Mailing Address - Country:US
Mailing Address - Phone:434-970-1393
Mailing Address - Fax:434-984-1297
Practice Address - Street 1:500 OLD LYNCHBURG RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-6500
Practice Address - Country:US
Practice Address - Phone:434-970-1393
Practice Address - Fax:434-984-1297
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006982251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health