Provider Demographics
NPI:1477197937
Name:WEST COAST THERAPY COLLECTIVE, A LICENSED MARRIAGE & FAMILY THERAPY CO
Entity Type:Organization
Organization Name:WEST COAST THERAPY COLLECTIVE, A LICENSED MARRIAGE & FAMILY THERAPY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-613-7073
Mailing Address - Street 1:171 SAXONY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6776
Mailing Address - Country:US
Mailing Address - Phone:760-724-3805
Mailing Address - Fax:844-594-2433
Practice Address - Street 1:171 SAXONY RD STE 104
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6776
Practice Address - Country:US
Practice Address - Phone:760-724-3805
Practice Address - Fax:844-594-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty