MEDICARE: GURTZ COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180.009623	IL

General Provider Information

NPI Number	:	1952777047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GURTZ COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1327 ROSE CT E
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-3256
Country	:	US
Telephone Number	:	847-502-1240
Fax Number	:	847-590-5900

Provider Business Practice Location Address
First Line	:	1327 ROSE CT E
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-3256
Country	:	US
Telephone Number	:	847-502-1240
Fax Number	:	847-590-5900

Authorized Official
Title or Position	:	OWNER
Name	:	GABRIELLE GURTZ
Credential	:	MS., LCPC
Telephone Number	:	847-502-1240

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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