Provider Demographics
NPI:1629789623
Name:THE MARRIAGE AND FAMILY CLINIC
Entity Type:Organization
Organization Name:THE MARRIAGE AND FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:I
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:720-648-8285
Mailing Address - Street 1:765 N MAIN ST BSMT
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1113
Mailing Address - Country:US
Mailing Address - Phone:385-283-0502
Mailing Address - Fax:
Practice Address - Street 1:765 N MAIN ST BSMT
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1113
Practice Address - Country:US
Practice Address - Phone:385-283-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MARRIAGE AND FAMILY CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty