Provider Demographics
NPI:1417323726
Name:COUPLE & RELATIONSHIP THERAPY: A MARRIAGE & FAMILY THERAPY PRACTICE
Entity Type:Organization
Organization Name:COUPLE & RELATIONSHIP THERAPY: A MARRIAGE & FAMILY THERAPY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:716-912-6339
Mailing Address - Street 1:4511 HARLEM RD RM 8
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3822
Mailing Address - Country:US
Mailing Address - Phone:716-912-6339
Mailing Address - Fax:
Practice Address - Street 1:4511 HARLEM RD RM 8
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3822
Practice Address - Country:US
Practice Address - Phone:716-912-6339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty