Carlisa Shavon Gilmer

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A1806074 Issued in AR

Practice address

301 Hurricane Dr
Jonesboro, AR 72401-4977

Phone

(870) 910-3757

NPI assigned

May 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1720578909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ALDERSGATE RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056676",
            "telephone_number": "501-661-0720",
            "fax_number": "501-325-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HURRICANE DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014977",
            "telephone_number": "870-910-3757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2707 Browns Ln",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724017213",
            "country_code": "US",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMER",
        "first_name": "CARLISA",
        "middle_name": "SHAVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1806074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine A Gillespie, M.D.
• Katlynne Michelle Gillespie, AU.D.
• Arnold Gilliam, M.D.
• Margo Gilliland
• Sarah K Gillis, LPN
• Lexi Ginevan
• Susan Ashley Ginn, LCSW
• Amy Danae Gipson, FNP
• Michael Gene Gipson, LCSW
• GL Cranfill MD PA

• Mental Health Counselor in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.