Provider Demographics
NPI:1154792646
Name:GILLIHAN, BRANDY (LMHCA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:GILLIHAN
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 CAPITAL MALL DR SW APT F302
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8790
Mailing Address - Country:US
Mailing Address - Phone:360-350-9594
Mailing Address - Fax:
Practice Address - Street 1:673 WOODLAND SQUARE LOOP SE
Practice Address - Street 2:SUITE 330
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1066
Practice Address - Country:US
Practice Address - Phone:888-364-9577
Practice Address - Fax:360-628-5240
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60585602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health