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General NPI Number Information
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NPI Number | 1548305048
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Entity Type | Individual
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Provider Name | GLORIA JEAN HIMES LPC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 111 N RIVER ST
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City | FENTON
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State | MI
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Zip | 48430-2696
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Country | US
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Telephone | 810-777-0250
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Fax | 810-208-0330
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Provider Business Mailing Address
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Address Line | 540 E SOUTH HOLLY RD
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City | FENTON
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State | MI
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Zip | 48430-2982
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Country | US
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Telephone | 810-624-6707
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Fax |
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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 | 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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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401015626
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E3705
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License Number State | OH
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