Provider Demographics
NPI:1295455228
Name:GILLIS, WESTIN (LCMHC-A)
Entity type:Individual
Prefix:MR
First Name:WESTIN
Middle Name:
Last Name:GILLIS
Suffix:
Gender:M
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9392 NC 105 S
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604
Mailing Address - Country:US
Mailing Address - Phone:828-266-5444
Mailing Address - Fax:
Practice Address - Street 1:717 GREENWAY RD STE C
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4991
Practice Address - Country:US
Practice Address - Phone:828-820-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health