DR. MARK CLIFFORD GILLEN (NPI# 1104830785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104830785 |
| Entity Type | Individual |
| Full Name | DR. MARK CLIFFORD GILLEN |
| Credential | LPC |
| Practice Address |
257 N Piety St Ellsworth WI 54011-5056 |
| Practice Telephone | 7154253890 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YP2500X |
Counselor Specialization: Professional |
913-125 | WI | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
3992-123 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609833078 | Mark R. Gillen | Physician Assistant | 6160 S Yale Ave, Tulsa, OK 74136-1930 | 2006-04-28 |
| Street Address |
257 N PIETY ST |
| City | ELLSWORTH |
| State | WI |
| Zip Code | 54011-5056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942864186 | Cb Therapy Group, LLC | Social Worker | 187 E Main Street, Ellsworth, WI 54011 | 2019-04-23 |
| 1124548201 | Samantha K Johnson | Chiropractor | 187 East Main, Ellsworth, WI 54011 | 2017-06-21 |
| 1609047869 | Shopko Stores Operating Co LLC | Pharmacy | 598 Lucas Lane, Ellsworth, WI 54011 | 2008-03-17 |
| 1134301955 | Ellsworth Community School District | Local Education Agency (LEA) | 300 Hillcrest St, Box 1500, Ellsworth, WI 54011 | 2007-12-04 |
| 1730219239 | Krisan Shaw | Dentist | 501 W. Lucas Lane, Ellsworth, WI 54011 | 2007-03-06 |
| 1770659658 | Pierce County Dept of Human Services | Community/Behavioral Health | 412 W Kinne Street, Ellsworth, WI 54011 | 2006-11-24 |
| 1629633912 | Village Pharmacy Healthcare Inc | Pharmacy | 157 E Main St, Ellsworth, WI 54011 | 2019-05-02 |
| 1396162020 | Shaw Family Dental Sc | Dentist | 501 W. Lucas Lane, Ellsworth, WI 54011 | 2014-03-19 |
| 1093085680 | Amy Alissa Kohls | Occupational Therapy Assistant | 403 N Maple St, Ellsworth Care Center, Ellsworth, WI 54011 | 2012-01-12 |
| 1659557510 | Ellsworth Chiropractic Inc | Chiropractor | 187 E Main St, Ellsworth, WI 54011 | 2008-01-10 |
| Find all providers in zip 54011 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346539731 | Jeanne Louise Lambrecht | Counselor | 26152 E 1300 North Rd, Ellsworth, IL 61737-9526 | 2011-04-06 |
| 1780817510 | Robert John Kenendy | Counselor | 4 State St, Suite A, Ellsworth, ME 04605-1938 | 2009-08-27 |
| 1063575876 | Lucia Patat Young | Counselor | 114 State St, Ellsworth, ME 04605-1831 | 2006-12-19 |
| 1033206321 | Charisse Astbury Stanko | Counselor | 226 High St, Ellsworth, ME 04605-1742 | 2006-10-06 |
| 1033204177 | Lynn Benson | Counselor | 10 Hancock St, Ellsworth, ME 04605-2015 | 2006-10-04 |
| 1821515339 | Pamela Jean Gagnon Da Silva | Counselor | 733 Bangor Rd, Ellsworth, ME 04605-3580 | 2017-08-25 |
| 1982958344 | Stacey G. Wood | Counselor | 415 Water St, Ellsworth, ME 04605-2116 | 2012-11-06 |
| 1477701225 | Kerry Beth Shea | Counselor | 53 Church St, Ellsworth, ME 04605-1915 | 2008-09-05 |
| 1487831434 | Cheryl M Nelson | Counselor | 194 Main St, Ellsworth, ME 04605-1939 | 2008-01-22 |
| 1558577510 | Kelly Elizabeth Pearson | Counselor | 415 Water St, Ellsworth, ME 04605-2116 | 2007-05-15 |
| Find all providers in ELLSWORTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.