MEDICARE: HEART TO HEART MARRIAGE AND FAMILY COUNSELING, 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1538814306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART TO HEART MARRIAGE AND FAMILY COUNSELING, INC.

Provider Business Mailing Address
First Line	:	909 OLIVER ST
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-1737
Country	:	US
Telephone Number	:	626-755-7740
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 OLIVER ST
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-1737
Country	:	US
Telephone Number	:	626-755-7740
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MILA RENKEN
Credential	:	LMFT
Telephone Number	:	626-755-7740

Provider Enumeration Date	:	02/19/2022
Last Update Date	:	02/19/2022

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