Healthcare Provider Details

I. General information

NPI: 1902854185
Provider Name (Legal Business Name): GAINESVILLE FAMILY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 NW 6TH STREET, SUITE C2
GAINESVILLE FL
32601-4277
US

IV. Provider business mailing address

1031 NW 6TH STREET, SUITE C2
GAINESVILLE FL
32601-4277
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-5543
  • Fax: 352-376-2042
Mailing address:
  • Phone: 352-376-5543
  • Fax: 352-376-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY0004709
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW0566
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT0000452
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT00001276
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT00001633
License Number StateFL

VIII. Authorized Official

Name: HERB STEIER
Title or Position: OWNER
Credential: PH.D.
Phone: 352-376-5543