Provider Demographics
NPI:1710768379
Name:HERE ON PURPOSE MARRIAGE AND FAMILY COUNSELING CORP.
Entity Type:Organization
Organization Name:HERE ON PURPOSE MARRIAGE AND FAMILY COUNSELING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-641-0979
Mailing Address - Street 1:10950 ARROW ROUTE
Mailing Address - Street 2:#3153
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729
Mailing Address - Country:US
Mailing Address - Phone:909-641-0979
Mailing Address - Fax:
Practice Address - Street 1:9797 FERRON BLVD,
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-641-0979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty