MEDICARE: MRM FAMILY COUNSELING SERVICES, 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	106H00000X	Marriage & Family Therapist	80212	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649395419	OTHER	CA	INDIVIDUAL NPI NUMBER

General Provider Information

NPI Number	:	1851756092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MRM FAMILY COUNSELING SERVICES, INC.

Provider Business Mailing Address
First Line	:	1300 E SHAW AVE STE 149
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-7903
Country	:	US
Telephone Number	:	559-554-9710
Fax Number	:	559-554-9711

Provider Business Practice Location Address
First Line	:	1300 E SHAW AVE STE 149
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-7903
Country	:	US
Telephone Number	:	559-554-9710
Fax Number	:	559-554-9711

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE RENEE MCCOY
Credential	:
Telephone Number	:	559-644-0436

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	04/14/2026

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