Michael William Gillum, MA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS007825L Issued in PA

Practice address

705 Washington Blvd Ste 100
Williamsport, PA 17701-5355

Phone

(570) 321-6390

Fax

(570) 321-6393

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sonya A Wolfrom, LSW

  • Clinical Social Worker
  • Williamsport, PA
  • NPI 1487996724
  Medicare reassignment

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gillum Psychological & Counseling Services

  • Cognitive & Behavioral Psychologist
  • Williamsport, PA
  • NPI 1003248451
  NPD (past) Authorized official
• Gillum Psychological & Counseling Services

  • Psychologist
  • Williamsport, PA
  • NPI 1891115119
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1194789180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WASHINGTON BLVD STE 100",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015355",
            "telephone_number": "570-321-6390",
            "fax_number": "570-321-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 WASHINGTON BLVD STE 100",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015355",
            "telephone_number": "570-321-6390",
            "fax_number": "570-321-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS007825L",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS007825L",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PA",
            "license": "PS007825L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001553383",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Getgen, MA
• Pauline Helena Gideon
• Corey Michael Gill, MD
• Gillum Psychological & Counseling Services
• Gillum Psychological & Counseling Services
• Emily C Glackin, CRNP
• Cameron Glagola, DO
• Kenneth Glaser, MD
• Jennifer Joy Glover Walker, LCSW
• Daniel Glunk

• Psychologist in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.