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Organization

GEORGIA INTERVENTIONS & FAMILY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GWENDOLYN M SLACKS BA (OFFICE ASSISTANT)
(229) 457-7205
Entity
Organization

Contact information

Practice address
115 S SHERMAN ST, FITZGERALD, GA 31750-2912
(229) 457-7205
Mailing address
239 KATHLEEN DR, FITZGERALD, GA 31750-7111
(229) 457-7205

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
Primary
103T00000X
Psychologist
106S00000X
Behavior Technician

Other

Enumeration date
06/01/2022
Last updated
06/01/2022
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