Provider Demographics
NPI:1467880450
Name:GILPIN, ANN LOUISE (MA, CAADC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:GILPIN
Suffix:
Gender:F
Credentials:MA, CAADC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:GILPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:677 E. MAIN ST.
Mailing Address - Street 2:STE. A
Mailing Address - City:CENTREVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49032
Mailing Address - Country:US
Mailing Address - Phone:269-467-1001
Mailing Address - Fax:269-467-3075
Practice Address - Street 1:111 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-5515
Practice Address - Country:US
Practice Address - Phone:229-219-1831
Practice Address - Fax:229-219-2832
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
MI101YA0400X, 101YM0800X
GAMSW010649104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health