Mary Gates-Gully in Centralia - Addiction (substance Use Disorder)
Mary Gates-Gully - NPI 1013105295
Mary Gates-Gully is a Addiction (substance Use Disorder) in Centralia, Illinois. Mary Gates-Gully practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Mary Gates-Gully is 1013105295. The last update date is 2018-02-07.
Mary Gates-Gully's current location address is 904 E. Martin Luther King Drive, Centralia, Illinois. You can contact this provider via phone number 6185331391 and fax number 6185330012. The mailing address for Mary Gates-Gully is 904 E. Martin Luther King Drive, Centralia, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Gates-Gully |
|---|---|
| Address | 904 E. Martin Luther King Drive, Centralia, Illinois |
| Phone Number | 6185331391 |
| Fax Number | 6185330012 |
| Sole Proprietor | N |
| Credentials | MS, CADC |
NPI Number Detail
| NPI Number | 1013105295 |
|---|---|
| Provider Enumeration Date | 2007-10-12 |
| Last Updated Date | 2018-02-07 |
Provider Mailing Address Detail
| Address | 904 E. Martin Luther King Drive |
|---|---|
| City | Centralia |
| State | Illinois (IL) |
| Post Code | 62801 |
| Phone Number | 6185331391 |
| Fax Number | 6185330012 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 21816 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 370915481007 | IL | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Mary Gates-Gully?
The Mary Gates-Gully has been issued the NPI (National Provider Identifier) 1013105295 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Mary Gates-Gully?
The Mary Gates-Gully is situated at 904 E. Martin Luther King Drive, in the city of Centralia, state of IL, with the zip code 62801.
What is the area of specialization for Mary Gates-Gully, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mary Gates-Gully is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this area of expertise is 101Ya0400X.
On what date did the Centers for Medicare & Medicaid Services issue the 1013105295 to Mary Gates-Gully?
The Mary Gates-Gully received its 1013105295 assignment from the Centers for Medicare & Medicaid Services on 2007-10-12.
When was the Mary Gates-Gully's information last updated?
The Mary Gates-Gully's information was last updated on 2018-02-07.
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