FOUNTAIN GATE LIFE AND WELLNESS, INC. (NPI# 1780966051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780966051 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN GATE LIFE AND WELLNESS, INC. |
| Other Organization Name | FOUNTAIN GATE COUNSELING CENTER |
| Practice Address |
2985 Cherokee St Nw Kennesaw GA 30144-2863 |
| Practice Telephone | 7702189005 |
| Practice Fax Number | 7704858481 |
| Mailing Telephone | 7702189005 |
| Mailing Fax Number | 7704858481 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2015-11-03 |
| Authorized Official Name | CRAIG TORELL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7702189005 |
| Authorized Official Credential | M.A., M.DIV., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Fountain Gate Counseling Center | Doing Business As Name - Organization |
| Street Address |
2985 CHEROKEE ST NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-2863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891260964 | Tara Dakin | Marriage & Family Therapist | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2018-10-04 |
| 1336591775 | My Secret Garden Counseling Service, LLC | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2016-07-11 |
| 1134571631 | Roxanna Litow | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2016-07-07 |
| 1447617410 | Margaret Ast | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2016-01-21 |
| 1063882074 | Flourish Counseling and Consulting LLC | Community/Behavioral Health | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2015-10-02 |
| 1689044901 | Jessica Richards | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2015-09-29 |
| 1447649066 | Sage Counseling Associates, LLC | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2015-01-20 |
| 1144628322 | Lamplight Counseling | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2014-12-19 |
| 1477823789 | Jenna Elizabeth Elliott | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2012-01-03 |
| 1093084113 | Elisa Torell | Counselor | 2985 Cherokee St Nw, Kennesaw, GA 30144-2863 | 2011-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241451 | Anila Asghar Malik | Counselor | 3164 Kirkwood Dr Nw, Kennesaw, GA 30144-2354 | 2019-12-04 |
| 1386289213 | Sarah Michelle Howell | Counselor | 1301 Shiloh Rd Nw Ste 340, Kennesaw, GA 30144-7151 | 2019-11-14 |
| 1558905992 | Edward Patrick Craven Jr. | Counselor | 3745 Cherokee St Nw Ste 607, Kennesaw, GA 30144-6733 | 2019-10-29 |
| 1831698869 | In Control Counseling Services, LLC | Counselor | 3895 Mountain View Rd Nw, Kennesaw, GA 30152-2388 | 2018-02-05 |
| 1619407020 | Pauline Waweru | Counselor | 1301 Shiloh Rd Nw Ste 1811, Kennesaw, GA 30144-7171 | 2017-06-18 |
| 1285161463 | Jennifer Y Hahn | Counselor | 3070 N Main St Nw Ofc 10, Kennesaw, GA 30144-2756 | 2017-05-18 |
| 1427590090 | Jennifer Lee Wells | Counselor | 1425 Ridenour Blvd Nw Apt 8108, Kennesaw, GA 30152-4570 | 2016-11-13 |
| 1104279637 | Gloria Dunston | Counselor | 1575 Ridenour Pkwy Nw, Apt. 1823, Kennesaw, GA 30152-4714 | 2016-07-20 |
| 1972961357 | Brent C Harris | Counselor | 4010 Sumit Wood Dr Nw, Kennesaw, GA 30152-4155 | 2016-02-01 |
| 1760888978 | Tiffany Webb | Counselor | 1301 Shiloh Rd Nw Ste 840, Kennesaw, GA 30144-7156 | 2014-11-15 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.