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General NPI Number Information
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NPI Number | 1427239086
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Entity Type | Individual
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Provider Name | JOSEPH MARTIN GORYL MA, LPC, LMSW
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Gender | Male
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 119 E SANILAC RD SUITE #3
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City | SANDUSKY
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State | MI
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Zip | 48471-1184
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Country | US
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Telephone | 810-648-4303
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Fax | 810-648-2988
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Provider Business Mailing Address
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Address Line | 119 E SANILAC RD SUITE #3
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City | SANDUSKY
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State | MI
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Zip | 48471-1184
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Country | US
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Telephone | 810-648-4303
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Fax | 810-648-2988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6401004005
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801016434
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License Number State | MI
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