Provider Demographics
NPI:1497178552
Name:SARAH MINELLA FAMILY THERAPY CENTER
Entity Type:Organization
Organization Name:SARAH MINELLA FAMILY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-246-6063
Mailing Address - Street 1:90 WASHINGTON ST
Mailing Address - Street 2:SUITE 301-E
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3744
Mailing Address - Country:US
Mailing Address - Phone:508-246-6063
Mailing Address - Fax:
Practice Address - Street 1:90 WASHINGTON ST
Practice Address - Street 2:SUITE 301-E
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3744
Practice Address - Country:US
Practice Address - Phone:508-246-6063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH164106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty