Provider Demographics
NPI:1851444335
Name:GILLIES, SARAH LYNN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYNN
Last Name:GILLIES
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35000 DIVISION RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-1566
Mailing Address - Country:US
Mailing Address - Phone:586-727-5529
Mailing Address - Fax:586-727-4922
Practice Address - Street 1:35000 DIVISION RD
Practice Address - Street 2:SUITE 2
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1566
Practice Address - Country:US
Practice Address - Phone:586-727-5529
Practice Address - Fax:586-727-4922
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI64010098701041C0700X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical