Organization
GANDOLFO ENTERPRISES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH PAUL GANDOLFO M.A., LPC (PRESIDENT)
(678) 640-0000
Entity
Organization
Contact information
Practice address
203 WOODPARK PL BLDG A, WOODSTOCK, GA 30188-3705
(678) 640-0000
Mailing address
203 WOODPARK PL BLDG A, WOODSTOCK, GA 30188-3705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003261312A
—
GA
Enumeration date
02/28/2022
Last updated
02/28/2022
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