Gateway Professional Services, PC
Counselor, Addiction (Substance Use Disorder) in Carbondale, IL. Organization (NPI-2).
NPI number1982242368
StatusActive
Last updated in NPPESJun 14, 2024
Details
- NPI
- 1982242368
- Entity type
- Organization (NPI-2)
- Legal business name
- Gateway Professional Services, PC
- Organization subpart
- Yes
- Enumeration date
- Dec 16, 2019
- Certification date
- Jun 14, 2024
- Last updated
- Jun 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
1080 E Park StCarbondale, IL 62901-3812
Phone 877-381-6538
Mailing address
55 E Jackson Blvd Ste 1500Chicago, IL 60604-4184
Phone 312-663-1130 · Fax 312-663-0504
Authorized official
Roueen Rafeyan
President
3126631130
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Other Addiction (Substance Use Disorder) Counselor providers in Carbondale, IL
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All 6 Addiction (Substance Use Disorder) Counselor providers in Carbondale · All 1,335 providers in Carbondale
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