Expressive Therapy Institute LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

MFT001573 Issued in GA

Legal business name

EXPRESSIVE THERAPY INSTITUTE LLC

Practice address

6015 Atlantic Blvd Ste a
Norcross, GA 30071-1343

Phone

(770) 361-4607

NPI assigned

Sep 25, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Annai Lopez Tavira Cruz, LMFTNPI 1982054409

Title

Child & Family Therapist

Phone

(770) 361-4607

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Annai Lopez Tavira Cruz, MFT, LMFT

  • Marriage & Family Therapist
  • Norcross, GA
  • NPI 1982054409
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1134638992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 WHITEHAVEN LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436666",
            "telephone_number": "770-361-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 ATLANTIC BLVD STE A",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711343",
            "telephone_number": "770-361-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Prospect Pl Ste 400",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300055468",
            "country_code": "US",
            "telephone_number": "770-361-4607",
            "fax_number": "888-977-1929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2440 Sandy Plains Rd Bldg 25",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300667232",
            "country_code": "US",
            "telephone_number": "770-971-9311 x7",
            "fax_number": "888-977-1929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXPRESSIVE THERAPY INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "LOPEZ TAVIRA CRUZ",
        "authorized_official_first_name": "ANNAI",
        "authorized_official_title_or_position": "CHILD & FAMILY THERAPIST",
        "authorized_official_telephone_number": "770-361-4607",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "MFT001573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galatia Jenee Everette
• Everkind Hospice, LLC
• Excelsior Healthcare Corp, PC
• Excelsior Healthcare LLC
• Excelsior Healthcare Partners LLC
• Extended Care Inc.
• Extendworks, Inc.
• Extrakare, LLC
• Terrence Dale Eyring, RPH
• Ifeanyi N. Ezunu, DDS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Norcross, GA
• Providers in Norcross, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.