Provider Demographics
NPI:1174034466
Name:OPEN HEART THERAPY
Entity Type:Organization
Organization Name:OPEN HEART THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:831-275-0879
Mailing Address - Street 1:409 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-3913
Mailing Address - Country:US
Mailing Address - Phone:831-275-0128
Mailing Address - Fax:831-491-2452
Practice Address - Street 1:311 FOREST AVE # 3B
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-3367
Practice Address - Country:US
Practice Address - Phone:831-402-3182
Practice Address - Fax:831-402-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100267106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty