Andrea Conner Marriage and Family Therapy Corp

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ANDREA CONNER MARRIAGE AND FAMILY THERAPY CORP

Practice address

19 Ditzhazy CT
Roseville, CA 95678-5944

Phone

(916) 407-4382

NPI assigned

Sep 19, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrea Conner, LMFT

Title

Ceo

Phone

(916) 407-4382

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1699497404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S. GRANT STREET",
            "address_2": "STE 110-#680",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782668",
            "telephone_number": "916-407-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DITZHAZY CT",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785944",
            "telephone_number": "916-407-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA CONNER MARRIAGE AND FAMILY THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-18",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-407-4382",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Roseville, CA
• Providers in Roseville, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.