Provider Demographics
NPI:1801434824
Name:THERAPY CENTERS OF DR. SUSAN LANDES, MFT, APC
Entity type:Organization
Organization Name:THERAPY CENTERS OF DR. SUSAN LANDES, MFT, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:LANDES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MFT
Authorized Official - Phone:530-888-9858
Mailing Address - Street 1:13620 LINCOLN WAY STE 380
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3269
Mailing Address - Country:US
Mailing Address - Phone:530-888-0985
Mailing Address - Fax:530-888-9805
Practice Address - Street 1:13620 LINCOLN WAY STE 380
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3269
Practice Address - Country:US
Practice Address - Phone:530-888-0985
Practice Address - Fax:530-888-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty