Healthcare Provider Details

I. General information

NPI: 1003577438
Provider Name (Legal Business Name): SUZY GALBRAITH, MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5276 HOLLISTER AVE STE 458
SANTA BARBARA CA
93111-4006
US

IV. Provider business mailing address

3715 MANDERINA CT
SANTA BARBARA CA
93105-4035
US

V. Phone/Fax

Practice location:
  • Phone: 805-335-2513
  • Fax:
Mailing address:
  • Phone: 805-680-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUZY GALBRAITH
Title or Position: OWNER
Credential: LMFT
Phone: 805-335-2513