Provider Demographics
NPI:1033842083
Name:GORRITZ, FRANK BRYAN (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:BRYAN
Last Name:GORRITZ
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 CLUB DR APT 1308
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-3030
Mailing Address - Country:US
Mailing Address - Phone:678-860-0688
Mailing Address - Fax:
Practice Address - Street 1:3525 CLUB DR APT 1308
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3030
Practice Address - Country:US
Practice Address - Phone:678-860-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012975101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor