Provider Demographics
NPI:1457124109
Name:HEARTS & BADGES FAMILY COUNSELING, INC
Entity Type:Organization
Organization Name:HEARTS & BADGES FAMILY COUNSELING, INC
Other - Org Name:HEARTS AND BADGES FAMILY COUNSELING, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/ OWNER/ LMFT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASINGAME
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-830-2727
Mailing Address - Street 1:2786 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-9255
Mailing Address - Country:US
Mailing Address - Phone:530-830-2727
Mailing Address - Fax:
Practice Address - Street 1:493 MAIN ST STE 210-B
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-9173
Practice Address - Country:US
Practice Address - Phone:530-391-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty