Provider Demographics
NPI:1932637998
Name:SCARPELLO, RICK JOSEPH (LMFT# 111512)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:JOSEPH
Last Name:SCARPELLO
Suffix:
Gender:M
Credentials:LMFT# 111512
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BRIDLE PATH LN
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-1468
Mailing Address - Country:US
Mailing Address - Phone:415-638-2660
Mailing Address - Fax:
Practice Address - Street 1:1500 GRANT AVE STE 126
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3181
Practice Address - Country:US
Practice Address - Phone:415-638-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist