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General NPI Number Information
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NPI Number | 1154725653
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Entity Type | Organization
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Legal Business Name | GONSKI COUNSELING PC
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 1608 W COLONIAL PKWY SUITE 201
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City | INVERNESS
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State | IL
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Zip | 60067-4755
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Country | US
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Telephone | 708-560-6653
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 W COLONIAL PKWY SUITE 201
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City | INVERNESS
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State | IL
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Zip | 60067-4755
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Country | US
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Telephone | 708-560-6653
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MELISSA GONSKI
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Credential | LCPC
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Telephone | 847-884-0210
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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 | 180007313
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License Number State | IL
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