Provider Demographics
NPI:1003021163
Name:SANTEE FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:SANTEE FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MFT PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:619-449-9937
Mailing Address - Street 1:9905 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4318
Mailing Address - Country:US
Mailing Address - Phone:619-449-9937
Mailing Address - Fax:619-449-1401
Practice Address - Street 1:9905 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4318
Practice Address - Country:US
Practice Address - Phone:619-449-9937
Practice Address - Fax:619-449-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 20237106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty