MEDICARE: PEACE AND PURPOSE MARRIAGE AND FAMILY THERAPY, PROFESSIONAL CORPORATION

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1326987561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE AND PURPOSE MARRIAGE AND FAMILY THERAPY, PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	512 PAULDING CIR
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-2857
Country	:	US
Telephone Number	:	805-556-5532
Fax Number	:

Provider Business Practice Location Address
First Line	:	512 PAULDING CIR
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-2857
Country	:	US
Telephone Number	:	805-556-5532
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIZABETH NIETO LONG
Credential	:	LMFT
Telephone Number	:	805-556-5532

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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