Provider Demographics
NPI:1144094939
Name:SCOVILLE, GILLIAN SHEFFIELD
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:SHEFFIELD
Last Name:SCOVILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E UINTAH ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2514
Mailing Address - Country:US
Mailing Address - Phone:719-357-8944
Mailing Address - Fax:
Practice Address - Street 1:525 E UINTAH ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2514
Practice Address - Country:US
Practice Address - Phone:719-357-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker