Provider Demographics
NPI:1346012341
Name:AMANDA FEINBERG MARRIAGE AND FAMILY THERAPIST, INC.
Entity Type:Organization
Organization Name:AMANDA FEINBERG MARRIAGE AND FAMILY THERAPIST, INC.
Other - Org Name:MELLOW THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:HALE
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-231-6162
Mailing Address - Street 1:4115 GLENCOE AVE APT 112
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-3800
Mailing Address - Country:US
Mailing Address - Phone:805-231-6162
Mailing Address - Fax:
Practice Address - Street 1:13101 W WASHINGTON BLVD # 217
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5131
Practice Address - Country:US
Practice Address - Phone:805-231-6162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty