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General NPI Number Information
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NPI Number | 1114503182
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Entity Type | Organization
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Legal Business Name | GEMS COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 10149 FORD AVENUE OFFICE #4
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City | RICHMOND HILL
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State | GA
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Zip | 31324
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Country | US
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Telephone | 912-507-3362
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BLUE MOON XING STE 3
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City | POOLER
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State | GA
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Zip | 31322-9798
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Country | US
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Telephone | 912-507-3362
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALISTS
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Name | KIMBERLY DAVIS
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Credential |
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Telephone | 912-373-4385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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