=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801765961
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WTF MARRIAGE AND FAMILY COUNSELING, PROFESSIONAL CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 68 RANCHO DR UNIT C
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95111-3479
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-257-2455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 115
-----------------------------------------------------
City | MARINA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93933-0115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-257-2455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | MELENY HONTS
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 760-524-8593
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------