Provider Demographics
NPI:1952082489
Name:EMBODIED RELATIONAL PSYCHOTHEARPY, A MARRIAGE AND FAMILY THERAPY CORP
Entity Type:Organization
Organization Name:EMBODIED RELATIONAL PSYCHOTHEARPY, A MARRIAGE AND FAMILY THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-493-8659
Mailing Address - Street 1:582 MARKET ST STE 1904
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5320
Mailing Address - Country:US
Mailing Address - Phone:114-154-9386
Mailing Address - Fax:
Practice Address - Street 1:582 MARKET ST STE 1904
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5320
Practice Address - Country:US
Practice Address - Phone:114-154-9386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty