Provider Demographics
NPI:1780332775
Name:WINSON, GEORGIA DEE (MS, LCPC)
Entity type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:DEE
Last Name:WINSON
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:MISS
Other - First Name:GEORGIA
Other - Middle Name:DEE
Other - Last Name:CRAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2824 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-6386
Mailing Address - Country:US
Mailing Address - Phone:217-787-8134
Mailing Address - Fax:
Practice Address - Street 1:2921 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6421
Practice Address - Country:US
Practice Address - Phone:217-546-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1800002805101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor