SQUARE ONE GJM NPI 1548974793

NPI Information

NPI: 1548974793
Provider Name: SQUARE ONE GJM
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
49 OLIVE ST
GALLIPOLIS, OH
ZIP 45631
Phone: (740) 441-5809
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SQUARE ONE GJM is a mental health counselor in Gallipolis, OH. SQUARE ONE GJM NPI is 1548974793. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

49 OLIVE ST
GALLIPOLIS, OH
ZIP 45631-632
Phone: (740) 441-5809
Fax: (740) 578-9242

The provider's authorized official is Sonya Jessie Hatem .
The authorized official title is Co Owner and has the following contact phone number (740) 441-5809.

The enumeration date for this NPI number is 1/12/2023 and was last updated on 1/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1447716352	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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