Family Service of the Tri-Cities

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FAMILY SERVICE OF THE TRI-CITIES

Practice address

39899 Balentine Dr
Suite 212
Newark, CA 94560-5355

Phone

(510) 791-3322

Fax

(510) 791-3325

NPI assigned

Dec 18, 2006

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ingrid J Theriault

Title

Executive Director

Phone

(510) 791-3322

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1912060393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39899 BALENTINE DR",
            "address_2": "SUITE 212",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945605355",
            "telephone_number": "510-791-3322",
            "fax_number": "510-791-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39899 BALENTINE DR",
            "address_2": "SUITE 212",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945605355",
            "telephone_number": "510-791-3322",
            "fax_number": "510-791-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF THE TRI-CITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "THERIAULT",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "510-791-3322"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Newark, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.