Provider Demographics
NPI:1063038552
Name:GILLESPIE, SARAH (MS, LPC INTERN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MS, LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2149
Mailing Address - Country:US
Mailing Address - Phone:832-423-0645
Mailing Address - Fax:
Practice Address - Street 1:5601 DEMOCRACY DR STE 255
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3699
Practice Address - Country:US
Practice Address - Phone:940-765-9029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82946101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor