Provider Demographics
NPI:1083126924
Name:GILLIGAN, EMILY (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GILLIGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NE GOLDIE ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4832
Mailing Address - Country:US
Mailing Address - Phone:360-679-5590
Mailing Address - Fax:
Practice Address - Street 1:1300 NE GOLDIE ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4832
Practice Address - Country:US
Practice Address - Phone:360-679-5590
Practice Address - Fax:360-675-1440
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO9926550104100000X
WALW614076521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker