Provider Demographics
NPI:1982276986
Name:ELIZABETH FOLIE MARRIAGE AND FAMILY THERAPIST
Entity Type:Organization
Organization Name:ELIZABETH FOLIE MARRIAGE AND FAMILY THERAPIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:FOLIE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:845-596-9053
Mailing Address - Street 1:525 N SYCAMORE AVE APT 225
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2056
Mailing Address - Country:US
Mailing Address - Phone:845-596-9053
Mailing Address - Fax:
Practice Address - Street 1:444 N LARCHMONT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3030
Practice Address - Country:US
Practice Address - Phone:424-291-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-11
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)