Provider Demographics
NPI:1861919078
Name:G. COLOMBINI COUNSELING, PLLC
Entity type:Organization
Organization Name:G. COLOMBINI COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIGI
Authorized Official - Middle Name:
Authorized Official - Last Name:COLOMBINI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-259-6290
Mailing Address - Street 1:630 N OLD WOODWARD AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3862
Mailing Address - Country:US
Mailing Address - Phone:248-259-6290
Mailing Address - Fax:248-282-7013
Practice Address - Street 1:630 N OLD WOODWARD AVE STE 303
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3862
Practice Address - Country:US
Practice Address - Phone:248-259-6290
Practice Address - Fax:248-282-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X, 261QM0855X
MI68010840801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health