MEDICARE: CAMILLE A COULTER LMFT

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	144139	CA

General Provider Information

NPI Number	:	1447767611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE A COULTER LMFT

Provider Business Mailing Address
First Line	:	1308 COURT ST
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-1635
Country	:	US
Telephone Number	:	530-605-0050
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 COURT ST
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-1635
Country	:	US
Telephone Number	:	530-605-0050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	03/12/2026

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Directions to “ CAMILLE A COULTER LMFT” Practice Location

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