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General NPI Number Information
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NPI Number | 1558900811
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Entity Type | Organization
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Legal Business Name | GORIS COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 310 UNION BLVD
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2115
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Country | US
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Telephone | 937-657-9154
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 LORD FITZWALTER DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-2090
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Country | US
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Telephone | 937-657-9154
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MR. JOHN WILLIAM GORIS
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Credential | LSW, LPCC-S
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Telephone | 937-657-9154
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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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