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General NPI Number Information
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NPI Number | 1639768344
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Entity Type | Organization
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Legal Business Name | COUNSELING ASSOCIATES OF MARIN, A LCSW ORGANIZATION
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Dates
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Enumeration Date | 01/16/2021
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Last Update Date | 01/16/2021
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Provider Practice Location Address
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Address Line | 240 MILLER AVE STE C
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City | MILL VALLEY
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State | CA
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Zip | 94941-2858
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Country | US
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Telephone | 415-946-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 145 CORTE MADERA TOWN CTR # 124
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City | CORTE MADERA
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State | CA
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Zip | 94925-1209
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Country | US
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Telephone | 415-936-9428
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA ROBERTSON VEYSSIERE
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Credential | LCSW
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Telephone | 415-936-9428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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