Provider Demographics
NPI:1760244586
Name:GILLEY, FAITH ANGUS (LMHC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ANGUS
Last Name:GILLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68-1845 WAIKOLOA RD # 106-121
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5584
Mailing Address - Country:US
Mailing Address - Phone:808-371-8975
Mailing Address - Fax:
Practice Address - Street 1:68-3678 KOKEE PLACE
Practice Address - Street 2:
Practice Address - City:WAIKOLA
Practice Address - State:HI
Practice Address - Zip Code:96738
Practice Address - Country:US
Practice Address - Phone:808-371-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health