Individual
MR. CURTIS GILLESPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3162 EL CAMINO DR, SPRINGFIELD, OH 45503-1318
(937) 342-9030
Mailing address
2475 WICKLIFFE RD, COLUMBUS, OH 43221-1835
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.964481
OH
101YP2500X
Professional Counselor
E.0001350-SUPV
OH
1041C0700X
Clinical Social Worker
Primary
I.0001981-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004375
ANTHEM
OH
01
—
197082000
MAGELLAN
OH
Enumeration date
10/31/2005
Last updated
06/24/2019
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