Healthcare Provider Details

I. General information

NPI: 1144135716
Provider Name (Legal Business Name): GAB RICH PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 QUEEN ANNE CT SE
MABLETON GA
30126-1432
US

IV. Provider business mailing address

4480 S COBB DR SE STE H-705
SMYRNA GA
30080-6990
US

V. Phone/Fax

Practice location:
  • Phone: 609-577-4524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLA RICH
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LCSW
Phone: 609-577-4524