Provider Demographics
NPI:1285244327
Name:GILLESPIE, EMILY JO ANN (LMHC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JO ANN
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1275
Mailing Address - Country:US
Mailing Address - Phone:317-873-8140
Mailing Address - Fax:
Practice Address - Street 1:8401 HARCOURT RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2036
Practice Address - Country:US
Practice Address - Phone:317-338-4604
Practice Address - Fax:317-338-4890
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99099844A101YM0800X
IN880001169A101YM0800X
IN39004454A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health