Healthcare Provider Details

I. General information

NPI: 1346163599
Provider Name (Legal Business Name): GOODELOVE MARRIAGE & FAMILY THERAPY & COACHING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MISSION ST # 208
SAN MARINO CA
91108-1632
US

IV. Provider business mailing address

4821 LANKERSHIM BLVD STE F242
NORTH HOLLYWOOD CA
91601-4538
US

V. Phone/Fax

Practice location:
  • Phone: 323-455-4775
  • Fax:
Mailing address:
  • Phone: 323-455-4775
  • 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: MINNIE L GOODE
Title or Position: CEO
Credential: LMFT
Phone: 323-455-4775