Provider Demographics
NPI:1629722079
Name:THE RESILIO COUNSELING GROUP, LLC
Entity Type:Organization
Organization Name:THE RESILIO COUNSELING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-438-6565
Mailing Address - Street 1:326 4TH ST APT 604
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1105
Mailing Address - Country:US
Mailing Address - Phone:907-438-6565
Mailing Address - Fax:
Practice Address - Street 1:326 4TH ST APT 604
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1105
Practice Address - Country:US
Practice Address - Phone:907-438-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health