Provider Demographics
NPI:1134668742
Name:MARKET STREET CENTER FOR PSYCHOTHERAPY
Entity Type:Organization
Organization Name:MARKET STREET CENTER FOR PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DI DONATO
Authorized Official - Suffix:
Authorized Official - Credentials:MFT39831
Authorized Official - Phone:415-431-3466
Mailing Address - Street 1:1231 MARKET ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1400
Mailing Address - Country:US
Mailing Address - Phone:415-431-3466
Mailing Address - Fax:
Practice Address - Street 1:1231 MARKET ST
Practice Address - Street 2:SUITE 810
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1400
Practice Address - Country:US
Practice Address - Phone:415-431-3466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty