Organization
GATEWAY COUNSELING INCORPORATED
Active
Organization
GATEWAY COUNSELING INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LYNN RICHARDSON LCSW (OWNER)
(208) 242-3771
Entity
Organization
Contact information
Practice address
151 N 3RD AVE STE 330, POCATELLO, ID 83201-6331
(208) 242-3771
(208) 242-3772
Mailing address
151 N 3RD AVE STE 330, POCATELLO, ID 83201-6331
(208) 242-3771
(208) 242-3772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
ID
251B00000X
Case Management Agency
—
ID
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/02/2011
Last updated
02/25/2020
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