Provider Demographics
NPI:1083240220
Name:CTG FAMILY THERAPY INC
Entity Type:Organization
Organization Name:CTG FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ROSALIE
Authorized Official - Last Name:LANGENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:323-627-1404
Mailing Address - Street 1:10444 SANTA MONICA BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5087
Mailing Address - Country:US
Mailing Address - Phone:323-627-1404
Mailing Address - Fax:
Practice Address - Street 1:10444 SANTA MONICA BLVD STE 403
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5087
Practice Address - Country:US
Practice Address - Phone:323-627-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty