Provider Demographics
NPI:1790492288
Name:BADAWY, NATALIE MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:BADAWY
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 1:11110 HORTENSE ST
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1720
Mailing Address - Country:US
Mailing Address - Phone:707-621-8913
Mailing Address - Fax:
Practice Address - Street 1:11110 HORTENSE ST
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-1720
Practice Address - Country:US
Practice Address - Phone:707-621-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135256106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty