Healthcare Provider Details

I. General information

NPI: 1508522731
Provider Name (Legal Business Name): THOUGHTFUL FAMILY THERAPY CENTERS A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 REDWOOD HWY FRONTAGE RD STE 1
MILL VALLEY CA
94941-1620
US

IV. Provider business mailing address

1038 REDWOOD HWY FRONTAGE RD STE 1
MILL VALLEY CA
94941-1620
US

V. Phone/Fax

Practice location:
  • Phone: 415-635-5494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM HERKELRATH
Title or Position: OWNER
Credential: LMFT
Phone: 415-635-5494