Individual provider · Type 1 NPI

Nicole Gilliam, SAC-IT, LPC-IT

Addiction (Substance Use Disorder) Counselor · Kenosha, WI

NPI number 1487527156 Active

Practice location

3825 39th Ave Ste 120
Kenosha, WI 53144-2043

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X20912 (WI)
Professional Counselor 101YP2500X8673 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1487527156

Nicole Gilliam, SAC-IT, LPC-IT's National Provider Identifier is 1487527156, issued on Sep 27, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kenosha, WI. The record was last updated on Oct 8, 2025.