Individual provider · Type 1 NPI

Mary Gates-Gully, MS, CADC

Addiction (Substance Use Disorder) Counselor · Centralia, IL

NPI number 1013105295 Active

Practice location

904 E. Martin Luther King Drive
Centralia, IL 62801

Call (618) 533-1391 Map

Fax (618) 533-0012

Other practice locations

  • 988 N Illinois Route 3, Waterloo, IL 62298-1000 · (618) 939-4444

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X21816 (IL)

Addiction (Substance Use Disorder) Counselor: Definition to come...

20 other providers at this address

Other addiction (substance use disorder) counselor providers in Centralia

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About NPI 1013105295

Mary Gates-Gully, MS, CADC's National Provider Identifier is 1013105295, issued on Oct 12, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Centralia, IL. The record was last updated on Feb 7, 2018.