Provider Demographics
NPI:1578279733
Name:WHOLE SPACE FAMILY THERAPY, INC
Entity Type:Organization
Organization Name:WHOLE SPACE FAMILY THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:LISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CEDS-S
Authorized Official - Phone:858-946-6823
Mailing Address - Street 1:16885 W BERNARDO DR STE 245
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1619
Mailing Address - Country:US
Mailing Address - Phone:858-946-6887
Mailing Address - Fax:
Practice Address - Street 1:16885 W BERNARDO DR STE 245
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1619
Practice Address - Country:US
Practice Address - Phone:858-946-6887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)