Individual
ANDREW GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 MESSIMER DR, NEWARK, OH 43055-1874
(740) 522-8477
Mailing address
95 MADISON AVE, NEWARK, OH 43055-6611
(740) 814-0048
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
111012-CS
OH
1041C0700X
Clinical Social Worker
Primary
I.0031525-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200008
—
OH
01
—
111012-CS
LICDC-CS
OH
01
—
I.0031525-S
LISW-S
OH
Enumeration date
12/20/2013
Last updated
12/20/2013
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