Healthcare Provider Details
I. General information
NPI: 1538080619
Provider Name (Legal Business Name): INTENTIONAL AND COMPASSIONATE FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
410 S EUCLID AVE APT 4
PASADENA CA
91101-3159
US
IV. Provider business mailing address
410 S EUCLID AVE APT 4
PASADENA CA
91101-3159
US
V. Phone/Fax
- Phone: 310-853-0764
- Fax: 213-726-0505
- Phone: 310-853-0764
- Fax: 213-726-0505
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
SPIEGEL
Title or Position: OWNER/OPERATOR
Credential: LMFT
Phone: 310-853-0764