Healthcare Provider Details

I. General information

NPI: 1568372233
Provider Name (Legal Business Name): GORGES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 RIDGE RD
LANSING IL
60438-3314
US

IV. Provider business mailing address

7116 S HONORE ST
CHICAGO IL
60636-3724
US

V. Phone/Fax

Practice location:
  • Phone: 773-977-2433
  • Fax:
Mailing address:
  • Phone: 773-899-5097
  • Fax: 773-434-9118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DARWIN GORDON
Title or Position: OWNER
Credential: LCSW, CADC
Phone: 773-899-5097