Provider Demographics
NPI:1306475264
Name:GIGIS, KATHERINE BARTLE (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BARTLE
Last Name:GIGIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 SILVER BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4009
Mailing Address - Country:US
Mailing Address - Phone:912-655-3707
Mailing Address - Fax:
Practice Address - Street 1:101 E MEMORIAL DR STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2728
Practice Address - Country:US
Practice Address - Phone:912-876-4010
Practice Address - Fax:912-369-2262
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health