Provider Demographics
NPI:1952489940
Name:GOOD SHEPHERD COUNSELING SERVICE INC
Entity Type:Organization
Organization Name:GOOD SHEPHERD COUNSELING SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIEL
Authorized Official - Suffix:
Authorized Official - Credentials:SPE
Authorized Official - Phone:615-451-7700
Mailing Address - Street 1:1139 SOUTH WRIGHTS LANE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066
Mailing Address - Country:US
Mailing Address - Phone:615-452-0030
Mailing Address - Fax:
Practice Address - Street 1:300 STEAM PLANT RD
Practice Address - Street 2:SUITE 440
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066
Practice Address - Country:US
Practice Address - Phone:615-451-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000001204101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty