Andrea N Gilliam

Primary specialty

CounselorTaxonomy code 101Y00000X

License

A2204011 Issued in AR

Practice address

800 Exchange Ave Ste 103
Conway, AR 72032-7833

Phone

(501) 781-2230

NPI assigned

Jun 24, 2022

Sex

Female

Sole proprietor

No

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

Locations

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.

• Chenal Family Therapy, PLC

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1356604219
  NPD

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1962134478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 FINANCIAL CENTRE PKWY STE 290",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113581",
            "telephone_number": "501-781-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EXCHANGE AVE STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327833",
            "telephone_number": "501-781-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "ANDREA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": "0014963",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A2204011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vickie Gibson, CMP
• Tayla Gil
• Stephanie San Gilbert
• Allison Collier Gill, M.S., CCC-A
• James Arthur Gillaspy Jr., PH.D.
• Shelby Gilmore
• Camdyn Gipson
• Virginia A Gipson, LCSW
• Freman Girdler, PHARMD
• NA'Shantia Girtman, QBHP

• Counselor in Conway, AR
• Providers in Conway, AR by specialty
• Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.