Corliss Gillespie, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004645 Issued in GA

Practice address

12531 Clipper Dr
Woodbridge, VA 22192-2355

Phone

(571) 402-2509

NPI assigned

Mar 6, 2007

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

Practice roles

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.

• Corliss Gillespie, LLC

  • Professional Counselor
  • Woodbridge, VA
  • NPI 1912464140
  NPD (past) Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1881724367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4090",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221944090",
            "telephone_number": "678-640-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12531 CLIPPER DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922355",
            "telephone_number": "571-402-2509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 S. Clinton St",
            "address_2": "Mailstop CT 05-13",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21224",
            "country_code": "US",
            "telephone_number": "678-640-3947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Piedmont Ave SE",
            "address_2": "Piedmont Hall Building",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033057",
            "country_code": "US",
            "telephone_number": "404-616-5917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "CORLISS",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie M Gibson, PT
• Shabbir H Gilani
• Hailey D Gill, PT, DPT
• Naurang Singh Gill, MD
• Amber Renee Gillespie, MSW
• Ana Cecilia Gilliam, LCSW
• Tupper D Gillie Sr., DPT
• Katharine Mary Gilligan, RPH.
• Jasmine Nakida Gillison, LPC
• Gina C Pham DDS PC

• Professional Counselor in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.