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General NPI Number Information
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NPI Number | 1104796333
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Entity Type | Organization
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Legal Business Name | TLW MARRIAGE & FAMILY THERAPY, INC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 4344 LATHAM ST STE 110
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City | RIVERSIDE
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State | CA
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Zip | 92501-1773
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Country | US
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Telephone | 909-684-1966
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Fax |
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Provider Business Mailing Address
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Address Line | 11799 SEBASTIAN WAY STE 103
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0708
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Country | US
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Telephone | 909-684-1966
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TENNILLE LINDSEYWRIGHT
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Credential | LMFT
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Telephone | 909-684-1966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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