Provider Demographics
NPI:1932216744
Name:GILLILAND, JAMES ANDREW (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:GILLILAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5281 S GENOA WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3758
Mailing Address - Country:US
Mailing Address - Phone:303-694-0752
Mailing Address - Fax:303-694-3290
Practice Address - Street 1:6081 S QUEBEC ST
Practice Address - Street 2:STE. 103
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4536
Practice Address - Country:US
Practice Address - Phone:303-694-0752
Practice Address - Fax:303-694-3290
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1842103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist