Provider Demographics
NPI:1265638852
Name:CONTI, MARI RAE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:MARI
Middle Name:RAE
Last Name:CONTI
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MABRY WAY
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2961
Mailing Address - Country:US
Mailing Address - Phone:310-406-5770
Mailing Address - Fax:
Practice Address - Street 1:139 MABRY WAY
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2961
Practice Address - Country:US
Practice Address - Phone:310-406-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist