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NPI Code Detail

MEDICARE: SLO COUNTY FAMILY THERAPY INC.

MEDICARE: SLO COUNTY FAMILY THERAPY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1144855339
Entity Type Code : Organization
Provider Name (Legal Business Name) : SLO COUNTY FAMILY THERAPY INC.
Provider Business Mailing Address
First Line : 441 MARSH ST
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6106
Country : US
Telephone Number : 805-234-8007
Fax Number :
Provider Business Practice Location Address
First Line : 441 MARSH ST
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6106
Country : US
Telephone Number : 805-234-8007
Fax Number :
Authorized Official
Title or Position : CEO
Name : CAMILLE JOHNSON
Credential : LMFT
Telephone Number : 805-234-8007
Provider Enumeration Date : 03/08/2020
Last Update Date : 05/18/2026

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Directions to “SLO COUNTY FAMILY THERAPY INC. ” Practice Location

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