Provider Demographics
NPI:1215114327
Name:GWINNETT FAMILY GUIDANCE CENTER
Entity type:Organization
Organization Name:GWINNETT FAMILY GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEURER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW, LMFT,LLSW
Authorized Official - Phone:770-449-0815
Mailing Address - Street 1:P.O. BOX 562
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30091-0562
Mailing Address - Country:US
Mailing Address - Phone:770-449-0815
Mailing Address - Fax:770-449-5759
Practice Address - Street 1:6045 ATLANTIC BLVD.
Practice Address - Street 2:SUITE 218
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1334
Practice Address - Country:US
Practice Address - Phone:770-449-0815
Practice Address - Fax:770-449-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000556LCSW1041C0700X
GA000476LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBFJTMedicare PIN