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General NPI Number Information
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NPI Number | 1184861858
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Entity Type | Organization
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Legal Business Name | NEIL GILBERT COUNSELING & HEALING LLC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 914 LINCOLNWAY W
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City | SOUTH BEND
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State | IN
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Zip | 46616-1152
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Country | US
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Telephone | 574-287-0391
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Fax |
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Provider Business Mailing Address
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Address Line | 914 LINCOLNWAY W
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City | SOUTH BEND
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State | IN
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Zip | 46616-1152
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Country | US
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Telephone | 574-287-0391
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NEIL GILBERT
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Credential | LCSW
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Telephone | 574-287-0391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 34002531A
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License Number State | IN
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