MEDICARE: GISELA RODRIGUEZ LAWSON LLC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1952118218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GISELA RODRIGUEZ LAWSON LLC

Provider Business Mailing Address
First Line	:	1930 W MILHAM AVE STE C
Second Line	:
City	:	PORTAGE
State	:	MI
Zip	:	49024-2228
Country	:	US
Telephone Number	:	269-779-3701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 W MILHAM AVE STE C
Second Line	:
City	:	PORTAGE
State	:	MI
Zip	:	49024-2228
Country	:	US
Telephone Number	:	269-389-0382
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL THERAPIST
Name	:	GISELA R LAWSON
Credential	:	LMSW
Telephone Number	:	269-779-3701

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	02/20/2026

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