Provider Demographics
NPI:1619267143
Name:BEHAVIOR THERAPY AND FAMILY COUNSELING CLINIC, INC.
Entity Type:Organization
Organization Name:BEHAVIOR THERAPY AND FAMILY COUNSELING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-706-9913
Mailing Address - Street 1:31416 AGOURA RD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4621
Mailing Address - Country:US
Mailing Address - Phone:818-706-9913
Mailing Address - Fax:805-491-8272
Practice Address - Street 1:31416 AGOURA RD
Practice Address - Street 2:SUITE 245
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4621
Practice Address - Country:US
Practice Address - Phone:818-706-9913
Practice Address - Fax:805-491-8272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10035103T00000X
CAMFC21169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty