Provider Demographics
NPI:1689431611
Name:BRITTANY M SEALEY-NEITRO MARRIAGE & FAMILY THERAPY INC
Entity Type:Organization
Organization Name:BRITTANY M SEALEY-NEITRO MARRIAGE & FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SEALEY-NEITRO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:707-495-6329
Mailing Address - Street 1:2629 CARSON WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2629 CARSON WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8272
Practice Address - Country:US
Practice Address - Phone:707-495-6329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health