Provider Demographics
NPI:1558805028
Name:BABINS, NEIL (MFTI)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:BABINS
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12255 BURBANK BLVD APT 218
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-5523
Mailing Address - Country:US
Mailing Address - Phone:818-641-3001
Mailing Address - Fax:
Practice Address - Street 1:12255 BURBANK BLVD APT 218
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-5523
Practice Address - Country:US
Practice Address - Phone:818-641-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-18
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF95530101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health