Healthcare Provider Details

I. General information

NPI: 1215114327
Provider Name (Legal Business Name): GWINNETT FAMILY GUIDANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6045 ATLANTIC BLVD. SUITE 218
NORCROSS GA
30071-1334
US

IV. Provider business mailing address

P.O. BOX 562
NORCROSS GA
30091-0562
US

V. Phone/Fax

Practice location:
  • Phone: 770-449-0815
  • Fax: 770-449-5759
Mailing address:
  • Phone: 770-449-0815
  • Fax: 770-449-5759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000476LMFT
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000556LCSW
License Number StateGA

VIII. Authorized Official

Name: MRS. LORETTA ANN STEURER
Title or Position: OWNER
Credential: MSW, ACSW, LMFT,LLSW
Phone: 770-449-0815