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General NPI Number Information
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NPI Number | 1669082293
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Entity Type | Organization
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Legal Business Name | LOVEWELL A MARRIAGE AND FAMILY THERAPY CORP
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 45 FRANKLIN ST STE 312
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6047
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Country | US
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Telephone | 310-729-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 45 FRANKLIN ST STE 312
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6047
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Country | US
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Telephone | 310-729-0073
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE, OWNER
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Name | MS. LAUREN KORSHAK
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Credential |
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Telephone | 415-937-8603
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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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