Provider Demographics
NPI:1689077307
Name:SERVIS, GIGI (PHD, LMHC, SUDP, MAC)
Entity Type:Individual
Prefix:
First Name:GIGI
Middle Name:
Last Name:SERVIS
Suffix:
Gender:F
Credentials:PHD, LMHC, SUDP, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 EVANS DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1228
Mailing Address - Country:US
Mailing Address - Phone:808-205-9537
Mailing Address - Fax:
Practice Address - Street 1:807 EVANS DR
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1228
Practice Address - Country:US
Practice Address - Phone:808-205-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60884835101YA0400X
WALH60878662101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty