Provider Demographics
NPI:1134976939
Name:UNECLIPSED COUNSELING, MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:UNECLIPSED COUNSELING, MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:619-587-3840
Mailing Address - Street 1:140 W FRANKLIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2725
Mailing Address - Country:US
Mailing Address - Phone:619-587-3840
Mailing Address - Fax:
Practice Address - Street 1:140 W FRANKLIN ST STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2725
Practice Address - Country:US
Practice Address - Phone:619-587-3840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty