Provider Demographics
NPI:1073219879
Name:NICOLE WILLIAMS MARRIAGE AND FAMILY THERAPY INC.
Entity Type:Organization
Organization Name:NICOLE WILLIAMS MARRIAGE AND FAMILY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMFT
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:KAFENHAUS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:831-222-0132
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-0412
Mailing Address - Country:US
Mailing Address - Phone:831-222-0132
Mailing Address - Fax:
Practice Address - Street 1:911 21ST ST STE 202
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1722
Practice Address - Country:US
Practice Address - Phone:831-222-0132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)