Provider Demographics
NPI:1992380257
Name:DANNER FAMILY THERAPY LLC
Entity Type:Organization
Organization Name:DANNER FAMILY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARI-ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-315-3128
Mailing Address - Street 1:223 N GUADALUPE ST # 119
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1868
Mailing Address - Country:US
Mailing Address - Phone:505-699-3156
Mailing Address - Fax:505-554-3435
Practice Address - Street 1:826 CAMINO DE MONTE REY STE A6
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3961
Practice Address - Country:US
Practice Address - Phone:505-699-3156
Practice Address - Fax:505-554-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty