=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336086552
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTER FOR HEALTHY MARRIAGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 CORPORATE POINTE STE 300
-----------------------------------------------------
City | CULVER CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90230-7620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-311-8891
-----------------------------------------------------
Fax | 310-564-2481
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 TIMBERLOCH PL STE 500
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-1375
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-311-8891
-----------------------------------------------------
Fax | 310-564-2481
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KONGIT SACK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 888-311-8891
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------