Provider Demographics
NPI:1245728468
Name:MEALER FAMILY THERAPY APC
Entity type:Organization
Organization Name:MEALER FAMILY THERAPY APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JEAN IRWIN
Authorized Official - Last Name:MEALER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-644-9323
Mailing Address - Street 1:27943 SECO CANYON ROAD #513
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350
Mailing Address - Country:US
Mailing Address - Phone:661-644-9323
Mailing Address - Fax:
Practice Address - Street 1:27201 TOURNEY ROAD #201-R
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-644-9323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105898106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty