Provider Demographics
NPI:1871985820
Name:GILL, MARGIE (LPC)
Entity type:Individual
Prefix:DR
First Name:MARGIE
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30515-0522
Mailing Address - Country:US
Mailing Address - Phone:678-804-8823
Mailing Address - Fax:678-804-8827
Practice Address - Street 1:1400 BUFORD HWY STE R4
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8777
Practice Address - Country:US
Practice Address - Phone:678-804-8823
Practice Address - Fax:678-804-8827
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-28
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional