Provider Demographics
NPI:1568060499
Name:ESSENTIAL PEACE OF MIND MARRIAGE AND FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:ESSENTIAL PEACE OF MIND MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-702-6212
Mailing Address - Street 1:9650 MILLIKEN AVE APT 4211
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6073
Mailing Address - Country:US
Mailing Address - Phone:323-702-6212
Mailing Address - Fax:
Practice Address - Street 1:9650 MILLIKEN AVE APT 4211
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6073
Practice Address - Country:US
Practice Address - Phone:323-702-6212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty