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GATEWAY PROFESSIONAL SERVICES PC NPI 1568164341


NPI Information

NPI: 1568164341
Provider Name: GATEWAY PROFESSIONAL SERVICES, PC
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
404 N HERSHEY RD STE C
BLOOMINGTON, IL
ZIP 61704
Phone: (877) 381-6538
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GATEWAY PROFESSIONAL SERVICES, PC is an adolescent and children mental health clinic center in Bloomington, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. GATEWAY PROFESSIONAL SERVICES, PC NPI is 1568164341. The provider is registered as an organization entity type.

The provider's business location address is:

404 N HERSHEY RD STE C
BLOOMINGTON, IL
ZIP 61704-560
Phone: (877) 381-6538

The provider's authorized official is Jeremy K Klemanski .
The authorized official title is Ceo and has the following contact phone number (312) 663-1130.

The enumeration date for this NPI number is 3/17/2023 and was last updated on 3/17/2023.


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
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.