Individual
PHILIP GASTINEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1836 BALDWIN ST, JENISON, MI 49428-8901
(616) 457-0016
Mailing address
6604 BLUE MIST RD, FORT WAYNE, IN 46819-1502
(260) 705-9347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
88000602A
IN
101YP2500X
Professional Counselor
Primary
—
MI
Other
Enumeration date
04/27/2018
Last updated
12/19/2024
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