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Individual

DR. MARK CLIFFORD GILLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
257 N PIETY ST, ELLSWORTH, WI 54011-5056
(715) 425-3890
Mailing address
257 N PIETY ST, ELLSWORTH, WI 54011-5056

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
913-125
WI
1041C0700X
Clinical Social Worker
Primary
3992-123
WI

Other

Enumeration date
07/28/2006
Last updated
09/11/2025
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