Provider Demographics
NPI:1508616046
Name:GENTLES COUSELING SERVICES
Entity Type:Organization
Organization Name:GENTLES COUSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIEKA
Authorized Official - Middle Name:ANNALIECIA
Authorized Official - Last Name:GENTLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-242-0312
Mailing Address - Street 1:100 GROVE ST STE 119
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2630
Mailing Address - Country:US
Mailing Address - Phone:774-420-2060
Mailing Address - Fax:774-530-6023
Practice Address - Street 1:100 GROVE ST STE 119
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2630
Practice Address - Country:US
Practice Address - Phone:774-420-2060
Practice Address - Fax:774-530-6023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)