Provider Demographics
NPI:1659860641
Name:NORTH BAY CHILD AND FAMILY COUNSELING, INC.
Entity Type:Organization
Organization Name:NORTH BAY CHILD AND FAMILY COUNSELING, INC.
Other - Org Name:NORTH BAY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-200-4211
Mailing Address - Street 1:250 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8385
Mailing Address - Country:US
Mailing Address - Phone:707-975-1330
Mailing Address - Fax:
Practice Address - Street 1:250 SUNSET LN
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8385
Practice Address - Country:US
Practice Address - Phone:707-975-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93495106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty