Provider Demographics
NPI:1750640975
Name:HENNESSEY, CELINA M (LMFT)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:M
Last Name:HENNESSEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3464
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-0464
Mailing Address - Country:US
Mailing Address - Phone:415-216-6140
Mailing Address - Fax:
Practice Address - Street 1:1500 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2513
Practice Address - Country:US
Practice Address - Phone:925-692-0090
Practice Address - Fax:925-692-0091
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist