Healthcare Provider Details

I. General information

NPI: 1902634082
Provider Name (Legal Business Name): MAYER THERAPY, AN INDIVIDUAL, MARRIAGE, AND FAMILY THERAPY PROFESSIONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOLITUDE TRL UNIT 3075
RENO NV
89523-9259
US

IV. Provider business mailing address

1100 SOLITUDE TRL UNIT 3075
RENO NV
89523-9259
US

V. Phone/Fax

Practice location:
  • Phone: 775-234-8869
  • Fax:
Mailing address:
  • Phone: 775-234-8869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: GREGORY MAYER
Title or Position: PRESIDENT
Credential: MFT
Phone: 775-234-8869