NPIMap

Organization Active NPI

Child Therapy Institute of Marin

  • Marriage & Family Therapist
  • San Anselmo, CA
National Provider Identifier
1821633348
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
CHILD THERAPY INSTITUTE OF MARIN
Practice address
558 San Anselmo Ave
San Anselmo, CA 94960-2621
Phone
(415) 456-7724
Fax
(415) 456-1050
NPI assigned
Nov 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Authorized official

Name
Sherie Shughart
Title
Administrative Assistant
Phone
(415) 456-7724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

558 San Anselmo Ave
San Anselmo, CA 94960-2621

Mailing address

1480 Lincoln Ave Ste 8
San Rafael, CA 94901-2085

National Provider Directory

National Provider Directory
Tax ID family
Child Therapy Institute21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

558 San Anselmo Ave
San Anselmo, CA 94960
Phone (415) 328-3202

NPI Registry JSON

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1821633348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 LINCOLN AVE STE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SAN ANSELMO AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602621",
            "telephone_number": "415-456-7724",
            "fax_number": "415-456-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD THERAPY INSTITUTE OF MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "SHUGHART",
        "authorized_official_first_name": "SHERIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "415-456-7724"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.