Provider Demographics
NPI:1952790636
Name:MARRIAGE AND FAMILY MATTERS, LLC
Entity type:Organization
Organization Name:MARRIAGE AND FAMILY MATTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:REGALADO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, LAC
Authorized Official - Phone:970-545-0402
Mailing Address - Street 1:410 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5324
Mailing Address - Country:US
Mailing Address - Phone:970-545-0402
Mailing Address - Fax:
Practice Address - Street 1:410 OAK ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5324
Practice Address - Country:US
Practice Address - Phone:970-545-0402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-18
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD0000277101YA0400X
COMFT0001148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty