Provider Demographics
NPI:1972928612
Name:GILLESPIE, KATHRYN (MSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:GILLESPIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:1390 OAK ST STE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3567
Mailing Address - Country:US
Mailing Address - Phone:541-686-6929
Mailing Address - Fax:541-686-3767
Practice Address - Street 1:1390 OAK ST STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3567
Practice Address - Country:US
Practice Address - Phone:541-912-6842
Practice Address - Fax:541-229-1263
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA33221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical