Provider Demographics
NPI:1831494350
Name:NICHOLAS FITTANTE ACT FAMILY COUNSELING SERVICES LMFT PC
Entity Type:Organization
Organization Name:NICHOLAS FITTANTE ACT FAMILY COUNSELING SERVICES LMFT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FITTANTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-983-5575
Mailing Address - Street 1:2545 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-6620
Mailing Address - Country:US
Mailing Address - Phone:909-983-5575
Mailing Address - Fax:909-983-1076
Practice Address - Street 1:2545 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6620
Practice Address - Country:US
Practice Address - Phone:909-983-5575
Practice Address - Fax:909-983-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty