Provider Demographics
NPI:1255403234
Name:FAMILY THERAPY SPECIALISTS, INC
Entity type:Organization
Organization Name:FAMILY THERAPY SPECIALISTS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:GLAS
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-448-7052
Mailing Address - Street 1:112 E 5TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2252
Mailing Address - Country:US
Mailing Address - Phone:952-448-7052
Mailing Address - Fax:952-448-7029
Practice Address - Street 1:112 E 5TH ST STE 202
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2252
Practice Address - Country:US
Practice Address - Phone:952-448-7052
Practice Address - Fax:952-448-7029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty