Provider Demographics
NPI:1891187316
Name:NORMANDI, CAROL (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:NORMANDI
Suffix:
Gender:F
Credentials:MS, 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 819
Mailing Address - Street 2:
Mailing Address - City:WOODACRE
Mailing Address - State:CA
Mailing Address - Zip Code:94973-0819
Mailing Address - Country:US
Mailing Address - Phone:415-488-1104
Mailing Address - Fax:888-832-5288
Practice Address - Street 1:523 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3347
Practice Address - Country:US
Practice Address - Phone:415-488-1104
Practice Address - Fax:888-832-5288
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist