Organization
FOUNTAIN GATE LIFE AND WELLNESS, INC.
Active
Other names
Fountain Gate Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG TORELL M.A., M.DIV., LPC (EXECUTIVE DIRECTOR)
(770) 218-9005
Entity
Organization
Contact information
Practice address
2985 CHEROKEE ST NW, KENNESAW, GA 30144-2863
(770) 218-9005
(770) 485-8481
Mailing address
2985 CHEROKEE ST NW, KENNESAW, GA 30144-2863
(770) 218-9005
(770) 485-8481
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/13/2011
Last updated
11/03/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up