Patrick Edward Gilliland, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001143 Issued in GA

Practice address

9635 Ventana Way
Suite 101
Johns Creek, GA 30022-8620

Phone

(678) 366-8862

Fax

(678) 739-0119

NPI assigned

Aug 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1386837052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 STONEY POINT RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417861",
            "telephone_number": "602-463-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 VENTANA WAY",
            "address_2": "SUITE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228620",
            "telephone_number": "678-366-8862",
            "fax_number": "678-739-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12140978",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.