Provider Demographics
NPI:1710501119
Name:SHAHEEN THERAPY CENTER INCORPORATION
Entity Type:Organization
Organization Name:SHAHEEN THERAPY CENTER INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:ELIA
Authorized Official - Last Name:SHAHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-839-0685
Mailing Address - Street 1:1024 N MACLAY AVE STE G
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-1361
Mailing Address - Country:US
Mailing Address - Phone:818-839-0685
Mailing Address - Fax:
Practice Address - Street 1:1024 N MACLAY AVE STE G
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1361
Practice Address - Country:US
Practice Address - Phone:818-839-0685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty