Provider Demographics
NPI:1891155172
Name:HOMEL-STOERCHLE, CYNTHIA JO (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JO
Last Name:HOMEL-STOERCHLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 SUMMERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-9281
Mailing Address - Country:US
Mailing Address - Phone:805-490-1167
Mailing Address - Fax:
Practice Address - Street 1:4810 MCEVER RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566
Practice Address - Country:US
Practice Address - Phone:678-971-4177
Practice Address - Fax:678-971-4185
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001453106H00000X
GAMFT001453106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist