Provider Demographics
NPI:1225610553
Name:STEPHANIE LAI THERAPY, A MARRIAGE & FAMILY THERAPY CORPORATION
Entity Type:Organization
Organization Name:STEPHANIE LAI THERAPY, A MARRIAGE & FAMILY THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-857-5372
Mailing Address - Street 1:PO BOX 641774
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94164-1774
Mailing Address - Country:US
Mailing Address - Phone:415-857-5372
Mailing Address - Fax:
Practice Address - Street 1:548 MARKET ST
Practice Address - Street 2:PMB 86394
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104
Practice Address - Country:US
Practice Address - Phone:415-857-5372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty