Provider Demographics
NPI:1336280791
Name:GILL, ALICE ANN (LMT LCSW OTRL)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:ANN
Last Name:GILL
Suffix:
Gender:F
Credentials:LMT LCSW OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 NW 32ND PLACE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:352-378-9723
Mailing Address - Fax:
Practice Address - Street 1:1204 NW 10TH AVENUE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601
Practice Address - Country:US
Practice Address - Phone:352-378-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW6332104100000X
FLMA5133225700000X
FLOT107225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z013COtherUPIN SOCIAL WORK LCSW
C5737Medicare UPIN
E6507Medicare ID - Type UnspecifiedSOCIAL WORK COVERED MEDIC