Provider Demographics
NPI:1225582638
Name:GORGES INC
Entity Type:Organization
Organization Name:GORGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMREIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-254-6055
Mailing Address - Street 1:1218 E 9TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5796
Mailing Address - Country:US
Mailing Address - Phone:405-949-5004
Mailing Address - Fax:405-563-9479
Practice Address - Street 1:1218 E 9TH ST STE 4
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5796
Practice Address - Country:US
Practice Address - Phone:405-949-5004
Practice Address - Fax:405-563-9479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty