NPIMap

Community Institute for Psychotherapy

Organization Active NPI Community/Behavioral Health Agency · San Rafael, CA

NPI 1780995258 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1780995258
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
X (CA)
Legal business name
COMMUNITY INSTITUTE FOR PSYCHOTHERAPY
Practice address
1330 Lincoln Ave
Suite 100
San Rafael, CA 94901-2120
Phone
(415) 459-5999
Fax
(415) 459-5602
NPI assigned
Jun 29, 2010
Organization subpart
No

Authorized official

Name
Dr. Robin J Berenson, PH. D.
Title
Executive Clinical Director
Phone
(415) 459-5999

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 136

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

View all 136

National Provider Directory

Tax ID family
Didi Hirsch Mental Health Services (140 organizations share this tax ID)

Locations

1330 Lincoln Ave
Ste 100
San Rafael, CA 94901
Phone (415) 260-9490

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X X CA Yes

Addresses

Primary practice location

1330 Lincoln Ave
Suite 100
San Rafael, CA 94901-2120

Mailing address

1330 Lincoln Ave
Suite 201
San Rafael, CA 94901-2120
Phone (415) 459-5999

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780995258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012120",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 100",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012120",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INSTITUTE FOR PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERENSON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "415-459-5999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

All providers in San Rafael, CA · Community/Behavioral Health Agency in California

Sources for this page

Verify at the official NPI Registry.