Provider Demographics
NPI:1881172336
Name:GULLICK, DENNIS DOUGLAS IV (MSW)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:DOUGLAS
Last Name:GULLICK
Suffix:IV
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MADISON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1230
Mailing Address - Country:US
Mailing Address - Phone:567-312-8700
Mailing Address - Fax:567-312-8793
Practice Address - Street 1:500 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1230
Practice Address - Country:US
Practice Address - Phone:567-312-8700
Practice Address - Fax:567-312-8793
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker