Provider Demographics
NPI:1073153367
Name:GENTLE BREEZE COUNSELING, LLC
Entity Type:Organization
Organization Name:GENTLE BREEZE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:541-824-0990
Mailing Address - Street 1:222 E 2ND ST # 4
Mailing Address - Street 2:
Mailing Address - City:COQUILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97423-1864
Mailing Address - Country:US
Mailing Address - Phone:541-824-0990
Mailing Address - Fax:541-824-0991
Practice Address - Street 1:222 E 2ND ST # 4
Practice Address - Street 2:
Practice Address - City:COQUILLE
Practice Address - State:OR
Practice Address - Zip Code:97423-1864
Practice Address - Country:US
Practice Address - Phone:541-824-0990
Practice Address - Fax:541-824-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty