Provider Demographics
NPI:1154725653
Name:GONSKI COUNSELING PC
Entity type:Organization
Organization Name:GONSKI COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-884-0210
Mailing Address - Street 1:1608 W COLONIAL PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4755
Mailing Address - Country:US
Mailing Address - Phone:708-560-6653
Mailing Address - Fax:
Practice Address - Street 1:1608 W COLONIAL PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4755
Practice Address - Country:US
Practice Address - Phone:708-560-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty