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General NPI Number Information
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NPI Number | 1437537594
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Entity Type | Organization
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Legal Business Name | INSIGHTFUL MATTERS FAMILY COUNSELING PROFESSIONALS
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Dates
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Enumeration Date | 05/09/2015
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 17111 BEACH BLVD SUITE 205
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5960
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Country | US
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Telephone | 714-654-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 17111 BEACH BLVD SUITE 205
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5960
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Country | US
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Telephone | 714-654-1570
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Fax |
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | ALISON LYNN JOHNSON
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Credential | MS, MFT
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Telephone | 714-654-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC49185
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License Number State | CA
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