Provider Demographics
NPI:1184861858
Name:NEIL GILBERT COUNSELING & HEALING LLC
Entity Type:Organization
Organization Name:NEIL GILBERT COUNSELING & HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:574-287-0391
Mailing Address - Street 1:914 LINCOLNWAY W
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46616-1152
Mailing Address - Country:US
Mailing Address - Phone:574-287-0391
Mailing Address - Fax:
Practice Address - Street 1:914 LINCOLNWAY W
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46616-1152
Practice Address - Country:US
Practice Address - Phone:574-287-0391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002531A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health