Provider Demographics
NPI:1629677166
Name:GLORIS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:GLORIS COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-SUPV, LICDC
Authorized Official - Phone:330-623-5387
Mailing Address - Street 1:5500 MARKET ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2624
Mailing Address - Country:US
Mailing Address - Phone:330-330-8332
Mailing Address - Fax:234-201-8390
Practice Address - Street 1:5500 MARKET ST STE 203
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2624
Practice Address - Country:US
Practice Address - Phone:330-330-8332
Practice Address - Fax:234-201-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-24
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0315372Medicaid