Michael Jerome Gilliard II, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC010398 Issued in GA

Practice address

50 Aviator PLZ Ste 105N
St Simons Island, GA 31522-0140

Phone

(404) 549-6987

Fax

(404) 795-5787

NPI assigned

Jun 5, 2017

Last updated

Apr 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Ujima Counseling, Consulting and Coaching LLC

  • Counselor
  • Brunswick, GA
  • NPI 1255895298
  NPD (past) Authorized official

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1598294571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LANTANA CT",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202211",
            "telephone_number": "843-471-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 AVIATOR PLZ STE 105N",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315220140",
            "telephone_number": "404-549-6987",
            "fax_number": "404-795-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIARD",
        "first_name": "MICHAEL",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.