Organization
GATEWAY COUNSELING INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS COLGROVE MS, LSW (PRESIDENT)
(317) 590-6139
Entity
Organization
Contact information
Practice address
7114 GALEN DR W STE 103, AVON, IN 46123-8659
(317) 590-6139
Mailing address
8103 E US HIGHWAY 36 # 243, AVON, IN 46123-7964
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000854A
IN
101YM0800X
Mental Health Counselor
39002164A
IN
101YP1600X
Pastoral Counselor
33003053A
IN
Other
Enumeration date
08/18/2017
Last updated
03/17/2018
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