Elvin Lance Ahl, MS, MDIV

Individual provider Active NPI Marriage & Family Therapist · Carlsbad, CA

NPI 1982969085 · NPPES record last updated May 9, 2015

Key facts

NPI
1982969085
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
86028 (CA)
Practice address
2782 Gateway Rd
Carlsbad, CA 92009-1730
Phone
(714) 222-0331
NPI assigned
Jul 5, 2012
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86028CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Therapy Center of SD, a MFT Corp Marriage & Family Therapist Current Accepting new patients

Locations

5650 El Camino Real
Ste 130
Carlsbad, CA 92008
Phone (714) 222-0331

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 86028 CA Yes

Addresses

Primary practice location

2782 Gateway Rd
Carlsbad, CA 92009-1730

Mailing address

1880 Key Largo Rd
Vista, CA 92081-7007
Phone (714) 222-0331

Other providers in Carlsbad, CA

All providers in Carlsbad, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.