Provider Demographics
NPI:1396893509
Name:GELFAN, CORINNE (LMFT)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:
Last Name:GELFAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13105 ALDERPOINT
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945
Mailing Address - Country:US
Mailing Address - Phone:530-265-7373
Mailing Address - Fax:
Practice Address - Street 1:206 PROVIDENCE MINE ROAD
Practice Address - Street 2:SUITE #215
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959
Practice Address - Country:US
Practice Address - Phone:530-265-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30364101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health