Basic Information
| Provider Information | |||||||||
| NPI: | 1275501975 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GATEWAYS COUNSELING, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2232 INDIANA AVE | ||||||||
| Address2: | SUITE ONE | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794102139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067936160 | ||||||||
| FaxNumber: | 8067990825 | ||||||||
| Practice Location | |||||||||
| Address1: | 2232 INDIANA AVE | ||||||||
| Address2: | SUITE ONE | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794102139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067936160 | ||||||||
| FaxNumber: | 8067990825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HENDRICKS | ||||||||
| AuthorizedOfficialFirstName: | BRET | ||||||||
| AuthorizedOfficialMiddleName: | CLAUDE | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHOTHERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 8067936160 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | I | ||||||||
| AuthorizedOfficialCredential: | ED.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 11526 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.