Provider Demographics
NPI:1952331134
Name:BEHAVIORAL HEALTH FAMILY COUNSELING & EDUCATIONAL CONSULTING, PC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH FAMILY COUNSELING & EDUCATIONAL CONSULTING, PC
Other - Org Name:BHFCEC
Other - Org Type:Other Name
Authorized Official - Title/Position:MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MFT
Authorized Official - Phone:530-758-7163
Mailing Address - Street 1:3415 BRETON AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2709
Mailing Address - Country:US
Mailing Address - Phone:530-758-1021
Mailing Address - Fax:530-758-1021
Practice Address - Street 1:2055 ANDERSON RD
Practice Address - Street 2:# 5
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0672
Practice Address - Country:US
Practice Address - Phone:530-758-7163
Practice Address - Fax:530-758-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty