Expansive Therapy a Professional Clinical Counselor Corporation

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EXPANSIVE THERAPY A PROFESSIONAL CLINICAL COUNSELOR CORPORATION

Practice address

582 Market St Ste 2002
San Francisco, CA 94104-5321

Phone

(415) 813-7407

NPI assigned

May 7, 2019

Organization subpart

No

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

Authorized official

Name

Nicholas Fager, LPCC

Title

Owner/Ceo

Phone

(415) 813-7407

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1821653593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 17TH ST APT E",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141993",
            "telephone_number": "415-813-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 MARKET ST STE 2002",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941045321",
            "telephone_number": "415-813-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPANSIVE THERAPY A PROFESSIONAL CLINICAL COUNSELOR CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "FAGER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "415-813-7407",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in San Francisco, CA
• Providers in San Francisco, 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 May 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.