Provider Demographics
NPI:1548305048
Name:HIMES, GLORIA JEAN (LPC)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:HIMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:JEAN
Other - Last Name:FARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:540 E SOUTH HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2982
Mailing Address - Country:US
Mailing Address - Phone:810-624-6707
Mailing Address - Fax:
Practice Address - Street 1:111 N RIVER ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2696
Practice Address - Country:US
Practice Address - Phone:810-777-0250
Practice Address - Fax:810-208-0330
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MI6401015626101YM0800X
OHE3705101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health