Provider Demographics
NPI:1962868067
Name:GOSIER, TERIS (DHA, MSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:TERIS
Middle Name:
Last Name:GOSIER
Suffix:
Gender:M
Credentials:DHA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 LEE RD # 1009
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3356
Mailing Address - Country:US
Mailing Address - Phone:470-523-3404
Mailing Address - Fax:470-220-7888
Practice Address - Street 1:2665 LEE RD # 1009
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3356
Practice Address - Country:US
Practice Address - Phone:470-523-3404
Practice Address - Fax:470-220-7888
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0224101YA0400X
IL1490275041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)