Gourley, Dennis R.
Gourley, Dennis R. is an sole proprietor health care provider with primary practice located at 480 Pierce Street Suite 112, Kingston PA 18704-5512. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gourley, Dennis R. can be contacted via phone (570) 714-0890.Contact Information
Primary practice address
480 Pierce Street Suite 112
Kingston PA 18704-5512
Phone: (570) 714-0890
Fax: (570) 714-0890
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CW013873 | Pennsylvania |
Profile Details
| NPI number | 1447346234 |
|---|---|
| LBN Legal business name | Gourley, Dennis R. |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Apr 16th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447346234 | NPPES |
| Pennsylvania | MEDICAID | 101659198 |
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