Kenneth Gillespie, PH.D, MS
Individual provider Active NPI Marriage & Family Therapist · Fairbanks, AK
NPI 1124613716 · NPPES record last updated Mar 4, 2021
Key facts
- NPI
- 1124613716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- Practice address
- 209 Forty Mile Ave
Fairbanks, AK 99701-3110 - Phone
- (907) 456-6445
- NPI assigned
- Mar 4, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science, Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Yes |
Addresses
Primary practice location
209 Forty Mile Ave
Fairbanks, AK 99701-3110
Mailing address
209 Forty Mile Ave
Fairbanks, AK 99701-3110
Phone (907) 456-6445
Other providers in Fairbanks, AK
- Valerie M Gifford
- Phillip E Gilbert
- Sena Marie Gilbert
- Jason Douglas Gillam
- Amy Gillespie
- Janet L Gilling
- Karin Gillis
- Lynn Gillitzer-Grover
- Barbara Gilson
- Madison Gingrow
All providers in Fairbanks, AK · Marriage & Family Therapist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.