MR. MICHAEL WILLIAM GILLUM (NPI# 1194789180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194789180 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL WILLIAM GILLUM |
| Credential | MA |
| Practice Address |
454 Pine St Williamsport PA 17701-6200 |
| Practice Telephone | 5703216390 |
| Practice Fax Number | 5703216393 |
| Mailing Telephone | 5703216390 |
| Mailing Fax Number | 5703216393 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | PS-007825-L | PA | Behavioral Health & Social Service Providers |
| X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PS-007825-L | PA | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS-007825-L | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730122276 | Michael D Gillum | Internal Medicine | 624 E Front Ave, Spokane, WA 99202-2139 | 2006-06-13 |
| Street Address |
454 PINE ST |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073025797 | Joseph Edward Dunn | Counselor | 454 Pine St, Williamsport, PA 17701-6200 | 2017-11-03 |
| 1568833515 | Edwin C Finch Phd | Preferred Provider Organization | 454 Pine St, Suite #2a, Williamsport, PA 17701-6200 | 2015-10-16 |
| 1891115119 | Gillum Psychological & Counseling Services | Social Worker | 454 Pine St, Suite 1b, Williamsport, PA 17701-6200 | 2014-04-25 |
| 1427488667 | Advocate Home Health Care & Private Duty | Custodial Care Facility | 454 Pine St, Glr, Williamsport, PA 17701-6200 | 2013-11-26 |
| 1003248451 | Gillum Psychological & Counseling Services | Psychologist | 454 Pine St, Suite 1b, Williamsport, PA 17701-6200 | 2013-08-07 |
| 1508145673 | Shirley Marie Larson | Social Worker | 454 Pine St, 2e4, Williamsport, PA 17701-6200 | 2011-08-08 |
| 1790964898 | Edwin Clarke Finch | Psychologist | 454 Pine St, Suite 2 S, Williamsport, PA 17701-6200 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316204399 | Mark A. Nevill | Psychologist | 2400 Reach Rd, Williamsport, PA 17701-4381 | 2012-04-16 |
| 1720237530 | Robert Joseph Meacham | Psychologist | 1965 Lycoming Creek Road Suite 208, The Carl E. Stotz Building, Williamsport, PA 17701 | 2008-09-17 |
| 1235275827 | Bruce G Anderson | Psychologist | 200 East St, Lycoming Clinton Joinder Board, Williamsport, PA 17701 | 2007-01-30 |
| 1508937814 | Peter W. Keely | Psychologist | 460 Market Street, Suite 165 A, Williamsport, PA 17701 | 2006-11-10 |
| 1356436869 | John Walter Kelsey | Psychologist | 811 Market Street, Williamsport, PA 17701 | 2006-10-03 |
| 1114997996 | David Glenn Rising | Psychologist | 1205 River Ave Fl 2, Williamsport, PA 17701-3724 | 2006-01-25 |
| 1841284502 | Hans C Philippen | Psychologist | 460 Market St, Ste 223, Williamsport, PA 17701-6385 | 2005-09-08 |
| 1083194310 | Erin Leigh Miller | Psychologist | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-08-16 |
| 1841688231 | Margaret Mary Hylton | Psychologist | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2015-01-07 |
| 1003248451 | Gillum Psychological & Counseling Services | Psychologist | 454 Pine St, Suite 1b, Williamsport, PA 17701-6200 | 2013-08-07 |
| Find all providers in WILLIAMSPORT | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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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.