Provider Demographics
NPI:1457995342
Name:SPERO PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:SPERO PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-898-5293
Mailing Address - Street 1:615 GREEN ST NW STE 201
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3378
Mailing Address - Country:US
Mailing Address - Phone:678-596-0032
Mailing Address - Fax:
Practice Address - Street 1:615 GREEN ST NW STE 201
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3378
Practice Address - Country:US
Practice Address - Phone:678-596-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)