Provider Demographics
NPI:1609865344
Name:GILLESPIE, KATHLEEN E (PHD)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:E
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:E
Other - Last Name:KESSLER-GILLESPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:9865 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1344
Mailing Address - Country:US
Mailing Address - Phone:623-876-1246
Mailing Address - Fax:623-933-5463
Practice Address - Street 1:9865 W BELL RD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1344
Practice Address - Country:US
Practice Address - Phone:623-876-1246
Practice Address - Fax:623-933-5463
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 1566101Y00000X
AZLISAC 10801101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)