Provider Demographics
NPI:1265024459
Name:GORIS COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:GORIS COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GORIS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, LPCC
Authorized Official - Phone:937-657-9154
Mailing Address - Street 1:1102 LORD FITZWALTER DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-2090
Mailing Address - Country:US
Mailing Address - Phone:937-657-9154
Mailing Address - Fax:
Practice Address - Street 1:1102 LORD FITZWALTER DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-2090
Practice Address - Country:US
Practice Address - Phone:937-657-9154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)