Provider Demographics
NPI:1164178463
Name:KASPER FAMILY THERAPY, INC,
Entity Type:Organization
Organization Name:KASPER FAMILY THERAPY, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:TACHA
Authorized Official - Last Name:KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-272-0729
Mailing Address - Street 1:8941 ATLANTA AVE # 297
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-7121
Mailing Address - Country:US
Mailing Address - Phone:949-272-0729
Mailing Address - Fax:
Practice Address - Street 1:895 DOVE ST FL 3
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2941
Practice Address - Country:US
Practice Address - Phone:949-272-0729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KASPER FAMILY THERAPY, INC,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty