Provider Demographics
NPI:1841317708
Name:COLVIN, LUCY J (MFT)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:J
Last Name:COLVIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22411
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-0411
Mailing Address - Country:US
Mailing Address - Phone:415-242-7919
Mailing Address - Fax:415-665-5044
Practice Address - Street 1:1801 BUSH ST STE 221
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5279
Practice Address - Country:US
Practice Address - Phone:415-820-9607
Practice Address - Fax:415-242-7919
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist