Provider Demographics
NPI:1922245943
Name:GILLIHAN, SETH JEFFERSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:JEFFERSON
Last Name:GILLIHAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 LANCASTER AVE
Mailing Address - Street 2:BUILDING E, 2ND FLOOR
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1547
Mailing Address - Country:US
Mailing Address - Phone:610-649-3265
Mailing Address - Fax:610-537-5059
Practice Address - Street 1:355 LANCASTER AVE
Practice Address - Street 2:BUILDING E, 2ND FLOOR
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1547
Practice Address - Country:US
Practice Address - Phone:610-649-3265
Practice Address - Fax:610-537-5059
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X
PAPS016766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral