Provider Demographics
NPI:1902984925
Name:GATEWAY COUNSELING GROUP LICENSED CLINICAL SOCIAL WORKERS INC
Entity Type:Organization
Organization Name:GATEWAY COUNSELING GROUP LICENSED CLINICAL SOCIAL WORKERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARNDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:559-251-9290
Mailing Address - Street 1:4991 E MCKINLEY AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1900
Mailing Address - Country:US
Mailing Address - Phone:559-251-9290
Mailing Address - Fax:559-251-1137
Practice Address - Street 1:4991 E MCKINLEY AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1900
Practice Address - Country:US
Practice Address - Phone:559-251-9290
Practice Address - Fax:559-251-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCO 130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty