Provider Demographics
NPI:1427208859
Name:DENNIS BROTMAN MARRIAGE AND FAMILY THERAPIST INC
Entity Type:Organization
Organization Name:DENNIS BROTMAN MARRIAGE AND FAMILY THERAPIST INC
Other - Org Name:LOS FELIZ COUNSELING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:BROTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:626-577-9728
Mailing Address - Street 1:PO BOX 80158
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91118-8158
Mailing Address - Country:US
Mailing Address - Phone:626-577-9728
Mailing Address - Fax:626-332-6587
Practice Address - Street 1:230 N MARYLAND
Practice Address - Street 2:SUITE 303
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206
Practice Address - Country:US
Practice Address - Phone:626-577-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health