Provider Demographics
NPI:1184793853
Name:MARR, GERALD STEVEN (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:STEVEN
Last Name:MARR
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 CHAPALA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3116
Mailing Address - Country:US
Mailing Address - Phone:805-453-0004
Mailing Address - Fax:
Practice Address - Street 1:1236 CHAPALA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3116
Practice Address - Country:US
Practice Address - Phone:805-965-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF43226101YM0800X
CA47762106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health