Couples Institute Counseling Services a Marriage and Family Therapy Co

Key facts

NPI: 1164052411
Entity type: Organization (NPI type 2)
Primary specialty: Mental Health Counselor 101YM0800X
Legal business name: COUPLES INSTITUTE COUNSELING SERVICES A MARRIAGE AND FAMILY THERAPY CO
Practice address: 3705 Haven Ave # 119
Menlo Park, CA 94025-1011
Phone: (650) 289-8603
NPI assigned: Jan 24, 2020
Organization subpart: No

Authorized official

Name: Stacy Lee NPI 1972756500
Title: Owner
Phone: (650) 308-9159

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Stacy Kathleen Lee Marriage & Family Therapist · Menlo Park, CA · NPI 1972756500

NPD Authorized official

National Provider Directory

Locations

3705 Haven Ave
#119
Menlo Park, CA 94025
Phone (650) 289-8603

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	101YM0800X			Yes

Addresses

Primary practice location

3705 Haven Ave # 119
Menlo Park, CA 94025-1011

Mailing address

3705 Haven Ave # 119
Menlo Park, CA 94025-1011
Phone (650) 289-8603

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 24, 2020.

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1164052411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 HAVEN AVE # 119",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251011",
            "telephone_number": "650-289-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 HAVEN AVE # 119",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251011",
            "telephone_number": "650-289-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUPLES INSTITUTE COUNSELING SERVICES A MARRIAGE AND FAMILY THERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-308-9159"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

All providers in Menlo Park, CA · Mental Health Counselor in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.