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General NPI Number Information
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NPI Number | 1366008021
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Entity Type | Organization
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Legal Business Name | GAINING EMOTIONAL AND MENTAL STABILITY, LLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 13421 FRANCIS LEWIS BLVD
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City | LAURELTON
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State | NY
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Zip | 11413-2539
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Country | US
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Telephone | 929-357-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 13421 FRANCIS LEWIS BLVD
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City | LAURELTON
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State | NY
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Zip | 11413-2539
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA EAGLE
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Credential | LMHC
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Telephone | 929-357-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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