Provider Demographics
NPI:1245837756
Name:GLEDHILL, JERRI (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:JERRI
Middle Name:
Last Name:GLEDHILL
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:JERRI
Other - Middle Name:
Other - Last Name:AVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:158 WESTLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-1808
Mailing Address - Country:US
Mailing Address - Phone:601-906-4434
Mailing Address - Fax:
Practice Address - Street 1:241 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2206
Practice Address - Country:US
Practice Address - Phone:769-231-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional