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NPI Code Detail

MEDICARE: JONATHAN LEE GOGAL ED.S., LPC, NCC

MEDICARE:   JONATHAN LEE GOGAL  ED.S., LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC015733GA

General Provider Information

NPI Number : 1871293621
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN LEE GOGAL ED.S., LPC, NCC
Provider Business Mailing Address
First Line : 1856 VALLEY SHOALS LN
Second Line :
City : BISHOP
State : GA
Zip : 30621-1397
Country : US
Telephone Number : 540-998-3498
Fax Number :
Provider Business Practice Location Address
First Line : 1856 VALLEY SHOALS LN
Second Line :
City : BISHOP
State : GA
Zip : 30621-1397
Country : US
Telephone Number : 540-315-1499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2023
Last Update Date : 05/13/2025

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Directions to “ JONATHAN LEE GOGAL ED.S., LPC, NCC” Practice Location

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