Healthcare Provider Details

I. General information

NPI: 1316860117
Provider Name (Legal Business Name): G'S CLINICAL CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 99TH AVE W
DULUTH MN
55810-2124
US

IV. Provider business mailing address

4102 99TH AVE W
DULUTH MN
55810-2124
US

V. Phone/Fax

Practice location:
  • Phone: 320-232-5388
  • Fax:
Mailing address:
  • Phone: 320-232-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: GEREMY M. ANDERSON
Title or Position: LICENSED ALCOHOL AND DRUG COUNSELOR
Credential: LADC
Phone: 320-232-5388