Provider Demographics
NPI:1003643727
Name:MARRIAGE & FAMILY SERVICES, INC.
Entity type:Organization
Organization Name:MARRIAGE & FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MUNDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:561-503-3059
Mailing Address - Street 1:15204 S JOG RD STE 303
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2171
Mailing Address - Country:US
Mailing Address - Phone:561-774-8225
Mailing Address - Fax:561-634-2776
Practice Address - Street 1:1725 W DR MARTIN LUTHER KING JR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6507
Practice Address - Country:US
Practice Address - Phone:561-774-8225
Practice Address - Fax:561-634-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty