Provider Demographics
NPI:1891333167
Name:MOUSHUMI GHOSE, MFT & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MOUSHUMI GHOSE, MFT & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOUSHUMI
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:323-739-4250
Mailing Address - Street 1:10649 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2341
Mailing Address - Country:US
Mailing Address - Phone:323-739-4250
Mailing Address - Fax:
Practice Address - Street 1:10649 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2341
Practice Address - Country:US
Practice Address - Phone:323-739-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty