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General NPI Number Information
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NPI Number | 1497409940
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Entity Type | Organization
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Legal Business Name | PEACEFUL HEART FAMILY COUNSELING, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1501 CORPORATE WAY STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95831-3887
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Country | US
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Telephone | 530-830-2699
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Fax | 916-244-0953
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Provider Business Mailing Address
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Address Line | 68 APPLEWOOD DR
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City | LODI
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State | CA
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Zip | 95242-8319
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Country | US
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Telephone | 530-830-2699
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MRS. MANIA DOUCETTE
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Credential | LMFT
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Telephone | 530-830-2699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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