Provider Demographics
NPI:1215182886
Name:PLATT MARRIAGE & FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:PLATT MARRIAGE & FAMILY THERAPY CORPORATION
Other - Org Name:TEEN SOLUTIONS, PASSION & PURPOSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:PLATT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CPC
Authorized Official - Phone:415-760-8541
Mailing Address - Street 1:311 MILLER AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2844
Mailing Address - Country:US
Mailing Address - Phone:415-760-8541
Mailing Address - Fax:815-301-9737
Practice Address - Street 1:311 MILLER AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2844
Practice Address - Country:US
Practice Address - Phone:415-760-8541
Practice Address - Fax:815-301-9737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35161106H00000X
CAMFC38930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty