Provider Demographics
NPI:1821549221
Name:GWANGI'S COUNSELLING LLC
Entity Type:Organization
Organization Name:GWANGI'S COUNSELLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHP
Authorized Official - Prefix:
Authorized Official - First Name:NIJA
Authorized Official - Middle Name:O
Authorized Official - Last Name:BONVILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS
Authorized Official - Phone:985-209-5172
Mailing Address - Street 1:250 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-3022
Mailing Address - Country:US
Mailing Address - Phone:985-209-5172
Mailing Address - Fax:
Practice Address - Street 1:250 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-3022
Practice Address - Country:US
Practice Address - Phone:985-209-5172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health