Provider Demographics
NPI:1477180388
Name:MORAN FAMILY COUNSELING
Entity Type:Organization
Organization Name:MORAN FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:442-222-1108
Mailing Address - Street 1:330 RANCHEROS DR STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2978
Mailing Address - Country:US
Mailing Address - Phone:442-222-1108
Mailing Address - Fax:
Practice Address - Street 1:330 RANCHEROS DR STE 208
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2978
Practice Address - Country:US
Practice Address - Phone:442-222-1108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)