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General NPI Number Information
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NPI Number | 1114113081
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Entity Type | Individual
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Provider Name | MICHELLE A MARCHESANO-BROWN LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 4768 PARK GRANADA SUITE 109
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City | CALABASAS
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State | CA
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Zip | 91302-1548
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Country | US
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Telephone | 818-754-4564
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1300
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City | THOUSAND OAKS
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State | CA
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Zip | 91358-0300
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Country | US
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Telephone | 805-405-6361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | MFC 53513
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License Number State | CA
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