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LAVENDER GROVE PSYCHOTHERAPY
NPI 1407465354
Social Worker - Clinical in Atlanta, GA

Active since July 27, 2020
3755 REDWINE RD, ATLANTA, GA 30344(404) 490-0031(404) 490-0031 Get Directions Write a Review

NPPES record last updated: July 27, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Lavender Grove Psychotherapy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAVENDER GROVE PSYCHOTHERAPY (NPI 1407465354) is a healthcare organization registered as a clinical in Atlanta, Georgia and active in the NPI registry since July 2020. The organization lists Extriara Charlesh Gates, Psychotherapist/ Owner, as its authorized official.

NPPES Registry Identity

NPI1407465354
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLAVENDER GROVE PSYCHOTHERAPY
Location Address3755 REDWINE RDAtlanta, GA 30344-5899
Mailing Address3755 Redwine Rd Apt 2216Atlanta, GA 30344-5932 · (404) 490-0031 · Fax (404) 490-0031
Phone(404) 490-0031
Fax(404) 490-0031
Organization SubpartNo
Authorized OfficialExtriara Charlesh GatesPsychotherapist/ Owner · (404) 490-0031
Enumeration DateJuly 27, 2020
NPPES CertifiedJuly 27, 2020
✔ NPI 1407465354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3755 REDWINE RD, Atlanta, GA 30344
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lavender Grove Psychotherapy's NPI number?

The NPI number for Lavender Grove Psychotherapy is 1407465354. It was assigned to this organization in the NPPES registry on July 27, 2020.

Where is Lavender Grove Psychotherapy located?

Lavender Grove Psychotherapy is located at 3755 Redwine Rd, Atlanta, GA 30344. The listed phone number is (404) 490-0031.

What is Lavender Grove Psychotherapy's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Lavender Grove Psychotherapy was last updated on July 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.