Healthcare Provider Details

I. General information

NPI: 1265281869
Provider Name (Legal Business Name): SMARTT LOVE THERAPY, A MARRIAGE & FAMILY THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2991 SACRAMENTO ST UNIT 269
BERKELEY CA
94702-2534
US

IV. Provider business mailing address

2991 SACRAMENTO ST UNIT 269
BERKELEY CA
94702-2534
US

V. Phone/Fax

Practice location:
  • Phone: 510-698-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ONAJE L. SMARTT
Title or Position: CEO
Credential: LMFT
Phone: 510-698-2273