Provider Demographics
NPI: | 1801502604 |
---|---|
Name: | YOURNOTALONE G COUNSELING & THERAPY SERVICES |
Entity type: | Organization |
Organization Name: | YOURNOTALONE G COUNSELING & THERAPY SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | LPC |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GERALDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WHITTEMORE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MED, LPC, CSC |
Authorized Official - Phone: | 956-579-4002 |
Mailing Address - Street 1: | 226 W HOUSTON ST APT 212 |
Mailing Address - Street 2: | |
Mailing Address - City: | PORT ISABEL |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78578-2948 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 956-579-4002 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 302 E QUEEN ISABELLA STE E |
Practice Address - Street 2: | |
Practice Address - City: | PORT ISABEL |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78578-2407 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-579-4002 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-01-25 |
Last Update Date: | 2024-10-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |