Provider Demographics
NPI:1295878908
Name:GILLIGAN, ANA M (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:GILLIGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1331
Mailing Address - Country:US
Mailing Address - Phone:407-246-6302
Mailing Address - Fax:
Practice Address - Street 1:501 N WYMORE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2808
Practice Address - Country:US
Practice Address - Phone:407-975-2565
Practice Address - Fax:407-975-2585
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW73201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical