Provider Demographics
NPI:1619630225
Name:G&G BEHAVIORAL HEALTH CONSULTANTS LLC
Entity Type:Organization
Organization Name:G&G BEHAVIORAL HEALTH CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMRICK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP
Authorized Official - Phone:618-697-5212
Mailing Address - Street 1:2265 STATE POND RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62952-2098
Mailing Address - Country:US
Mailing Address - Phone:157-327-5703
Mailing Address - Fax:
Practice Address - Street 1:2265 STATE POND RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:IL
Practice Address - Zip Code:62952-2098
Practice Address - Country:US
Practice Address - Phone:157-327-5703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty