Healthcare Provider Details

I. General information

NPI: 1184947871
Provider Name (Legal Business Name): P & G COUNSELING AND EDUCATION INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 RHODE ISLAND NE
WASHINGTON DC
20018
US

IV. Provider business mailing address

2218 RHODE ISLAND AVE NE
WASHINGTON DC
20018-2827
US

V. Phone/Fax

Practice location:
  • Phone: 202-526-3880
  • Fax: 202-526-3944
Mailing address:
  • Phone: 202-526-3880
  • Fax: 202-526-3944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPRC204
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPRC 204
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC204
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC204
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPRC204
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPRC204
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPRC204
License Number StateDC

VIII. Authorized Official

Name: MR. JOHN V GAMBLE
Title or Position: PSYCHOTHERAPY/CEO
Credential: LPC,CCDVC,MAC
Phone: 202-526-3880