Provider Demographics
NPI:1053067389
Name:JESSY GIGOWSKI LLC
Entity Type:Organization
Organization Name:JESSY GIGOWSKI LLC
Other - Org Name:JESSY GIGOWSKI LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIGOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-213-1621
Mailing Address - Street 1:236 S ANGOLA RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9501
Mailing Address - Country:US
Mailing Address - Phone:616-213-1621
Mailing Address - Fax:
Practice Address - Street 1:236 S ANGOLA RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9501
Practice Address - Country:US
Practice Address - Phone:616-213-1621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty