Organization
GILLUM PSYCHOLOGICAL & COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WILLIAM GILLUM M.A. (OWNER/DIRECTOR)
(570) 321-6390
Entity
Organization
Contact information
Practice address
705 WASHINGTON BOULEVARD, SUITE 100, WILLIAMSPORT, PA 17701-5355
(570) 321-6390
(570) 321-6393
Mailing address
705 WASHINGTON BOULEVARD, SUITE 100, WILLIAMSPORT, PA 17701-5355
(570) 321-6390
(570) 321-6393
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001553383
—
PA
Enumeration date
08/07/2013
Last updated
01/31/2025
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