Individual
TIMOTHY GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LPCS, MAC, CDCI
Contact information
Practice address
110 N WILLOW ST, KENAI, AK 99611-7701
(907) 398-0524
(888) 678-2961
Mailing address
PO BOX 1692, KENAI, AK 99611-1692
(907) 398-0524
(888) 678-2961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
508906
AK
101YP2500X
Professional Counselor
Primary
624
AK
Other
Enumeration date
09/16/2010
Last updated
01/30/2017
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