Healthcare Provider Details

I. General information

NPI: 1629677166
Provider Name (Legal Business Name): GLORIS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 MARKET ST STE 203
BOARDMAN OH
44512-2624
US

IV. Provider business mailing address

5500 MARKET ST STE 203
BOARDMAN OH
44512-2624
US

V. Phone/Fax

Practice location:
  • Phone: 330-330-8332
  • Fax: 234-201-8390
Mailing address:
  • Phone: 330-330-8332
  • Fax: 234-201-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GLORIS A GRIFFIN
Title or Position: OWNER
Credential: LPCC-SUPV, LICDC
Phone: 330-623-5387