Provider Demographics
NPI:1942653365
Name:HORN, CHARITY (LMFT)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:HORN
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 1:50 IRON POINT CIR STE 140
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8594
Mailing Address - Country:US
Mailing Address - Phone:503-206-1120
Mailing Address - Fax:
Practice Address - Street 1:50 IRON POINT CIR STE 140
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8594
Practice Address - Country:US
Practice Address - Phone:503-206-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA129875106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist