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General NPI Number Information
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NPI Number | 1457124109
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Entity Type | Organization
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Legal Business Name | HEARTS & BADGES FAMILY COUNSELING, INC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 493 MAIN ST STE 210-B
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City | DIAMOND SPRINGS
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State | CA
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Zip | 95619-9173
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Country | US
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Telephone | 530-391-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 2786 CAMBRIDGE RD
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City | CAMERON PARK
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State | CA
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Zip | 95682-9255
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Country | US
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Telephone | 530-830-2727
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Fax |
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Authorized Official
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Title or Position | CEO/ OWNER/ LMFT
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Name | KRISTIE BLASINGAME
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Credential | LMFT
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Telephone | 530-830-2727
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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 |
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License Number State |
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