Provider Demographics
NPI:1710567284
Name:WOODALL, GIGI
Entity type:Individual
Prefix:
First Name:GIGI
Middle Name:
Last Name:WOODALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 E FLORIDA AVE STE 915
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2549
Mailing Address - Country:US
Mailing Address - Phone:720-765-7807
Mailing Address - Fax:
Practice Address - Street 1:3801 E FLORIDA AVE STE 915
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2549
Practice Address - Country:US
Practice Address - Phone:310-836-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2025-01-22
Deactivation Date:2025-01-03
Deactivation Code:
Reactivation Date:2025-01-15
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health