Foy Butch Gilliam Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7908C Issued in AR

Practice address

1521 Merrill Dr Ste E200
Little Rock, AR 72211-1821

Phone

(501) 660-6893

Fax

(501) 974-7798

NPI assigned

Jan 7, 2013

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

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1669719951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251970",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251970",
            "telephone_number": "501-666-8686",
            "fax_number": "501-660-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 MERRILL DR STE E200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111821",
            "telephone_number": "501-660-6893",
            "fax_number": "501-974-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "FOY",
        "middle_name": "BUTCH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7908C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Lee Gillespie, AGACNP-BC
• Ethan Gillett, M.D.
• Michelle Gillett, MSN-RN
• Danyell Gilliam
• David L Gilliam, M.D.
• Nancy Denise Gilliam, PHD
• Ricardo Gilliam
• Sydney Raye Gilliam
• Lisa Gilliard
• Lindsey Gillis, SLP

• Clinical Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.