Provider Demographics
NPI:1013247535
Name:GILLILAND, PAUL CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:GILLILAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 GREENVILLE AVE # 104-553
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2925
Mailing Address - Country:US
Mailing Address - Phone:214-803-7447
Mailing Address - Fax:
Practice Address - Street 1:14504 EAGLEMONT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-2732
Practice Address - Country:US
Practice Address - Phone:214-803-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical