Individual
MR. PATRICK EDWARD GILLILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
9635 VENTANA WAY, SUITE 101, JOHNS CREEK, GA 30022-8620
(678) 366-8862
(678) 739-0119
Mailing address
2106 STONEY POINT RD, CUMMING, GA 30041-7861
(602) 463-5673
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
MFT001143
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12140978
CAQH
GA
Enumeration date
08/24/2007
Last updated
09/16/2013
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