Provider Demographics
NPI:1336793405
Name:ACCESSIBLE DBT, A CORPORATION FOR PSYCHOTHERAPY
Entity Type:Organization
Organization Name:ACCESSIBLE DBT, A CORPORATION FOR PSYCHOTHERAPY
Other - Org Name:ACCESSIBLE DBT, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-709-1648
Mailing Address - Street 1:9008 ELK GROVE BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1945
Mailing Address - Country:US
Mailing Address - Phone:916-709-1648
Mailing Address - Fax:916-688-3997
Practice Address - Street 1:9008 ELK GROVE BLVD STE 20
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1945
Practice Address - Country:US
Practice Address - Phone:916-709-1648
Practice Address - Fax:916-688-3997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-27
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty