Provider Demographics
NPI:1447821004
Name:GLEDHILL, MARSHALL HARRISON (CADC-I)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:HARRISON
Last Name:GLEDHILL
Suffix:
Gender:M
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HOT SPRINGS RD APT 204
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0947
Mailing Address - Country:US
Mailing Address - Phone:775-530-9424
Mailing Address - Fax:
Practice Address - Street 1:119 E LONG ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-2505
Practice Address - Country:US
Practice Address - Phone:775-530-9424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06862-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)