Gwynn S Colvin, LPC
Individual provider Active NPI Mental Health Counselor · Vidalia, GA
NPI 1457560625 · NPPES record last updated Dec 27, 2016
Key facts
- NPI
- 1457560625
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 006222 (GA)
- Practice address
- 1505 Meadows LN
Vidalia, GA 30474-4424 - Phone
- (912) 403-1544
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006222 | GA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 006222 | GA | Yes |
Addresses
Primary practice location
1505 Meadows LN
Vidalia, GA 30474-4424
Mailing address
1505 Meadows LN
Vidalia, GA 30474-4424
Phone (912) 403-1544
Other providers in Vidalia, GA
- Adam Joseph Cobb
- Allahna Allybia Coggins
- Julie Castleman Coleman
- Katherine Collins
- Paige Collins
- Angela Combs
- Paul Russell Combs
- Jessica Lynn Conant
- F. Geoffery Conner
- Consultants in Pain Medicine,LLC
All providers in Vidalia, GA · Mental Health Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.