Provider Demographics
NPI:1255349056
Name:MANTECON FAMILY COUNSELING INC
Entity type:Organization
Organization Name:MANTECON FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATED INDIVIDUAL
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MANTECON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:949-347-8755
Mailing Address - Street 1:28570 MARGUERITE PKWY
Mailing Address - Street 2:L-2 MANTECON FAMILY COUNSELING INC
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692
Mailing Address - Country:US
Mailing Address - Phone:949-347-8755
Mailing Address - Fax:
Practice Address - Street 1:28570 MARGUERITE PKWY
Practice Address - Street 2:L-2 MANTECON FAMILY COUNSELING INC
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692
Practice Address - Country:US
Practice Address - Phone:949-347-8755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty