Healthcare Provider Details

I. General information

NPI: 1043586845
Provider Name (Legal Business Name): RAFAEL COURET M.S., LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 11TH ST
REEDLEY CA
93654-2926
US

IV. Provider business mailing address

40 E MINARETS AVE
PINEDALE CA
93650-1239
US

V. Phone/Fax

Practice location:
  • Phone: 855-343-1057
  • Fax: 559-436-4650
Mailing address:
  • Phone: 559-436-0482
  • Fax: 559-436-4650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number98944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: