CHILD THERAPY INSTITUTE OF MARIN (NPI# 1619014081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619014081 |
| Entity Type | Organization |
| Organization Name | CHILD THERAPY INSTITUTE OF MARIN |
| Practice Address |
1480 Lincoln Ave Ste 8 San Rafael CA 94901-2085 |
| Practice Telephone | 4154567724 |
| Practice Fax Number | 4154561050 |
| Mailing Telephone | 4154567724 |
| Mailing Fax Number | 4154561050 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-19 |
| Authorized Official Name | DR. BRIAN LUKAS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4154567724 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073074324 | Child Therapy Institute of Marin | Community/Behavioral Health | 3195 California St Ste D, San Francisco, CA 94115-2412 | 2019-03-28 |
| 1760891931 | Child Therapy Institute of Marin | Clinic/Center | 2300 Martin Luther King Jr Way, Resource Room, Berkeley, CA 94704-1412 | 2014-08-12 |
| 1487092144 | Child Therapy Institute of Marin | Community/Behavioral Health | 2015 Virginia St, Berkeley, CA 94709-2229 | 2013-06-04 |
| 1265790489 | Child Therapy Institute of Marin | Community/Behavioral Health | 92 Louise Street, San Rafael, CA 94901 | 2012-04-25 |
| 1821633348 | Child Therapy Institute of Marin | Marriage & Family Therapist | 558 San Anselmo Ave, San Anselmo, CA 94960-2621 | 2019-11-07 |
| 1134641731 | Child Therapy Institute of Marin | Clinic/Center | 11100 San Pablo Ave Ste 205, El Cerrito, CA 94530-2100 | 2017-07-14 |
| 1790216489 | Child Therapy Institute of Marin | Community/Behavioral Health | 240 Tamal Vista Blvd, #155, Corte Madera, CA 94925-1132 | 2017-03-23 |
| 1801256300 | Child Therapy Institute of Marin | Community/Behavioral Health | 700 E St, San Rafael, CA 94901-2762 | 2016-02-26 |
| 1154713774 | Child Therapy Institute of Marin | Clinic/Center | 720 Southpoint Blvd, Petaluma, CA 94954-7495 | 2015-02-19 |
| 1497935308 | Child Therapy Institute of Marin | Community/Behavioral Health | 2926 Lone Tree Way, Antioch, CA 94509-4924 | 2007-11-07 |
| Street Address |
1480 LINCOLN AVE STE 8 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-2085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033730163 | Fabiola Aminta Navarrete Hernandez | Student in an Organized Health Care Education/Training Program | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2020-04-29 |
| 1669954855 | Terri Joanne Weber | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2018-09-04 |
| 1356897425 | Lily Jaser | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2016-08-29 |
| 1801220942 | Megan Carney | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2013-08-26 |
| 1912286444 | Lena Gozurian | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2011-08-15 |
| 1972810018 | Tiffany Cotter | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2010-09-10 |
| 1962523373 | Virginia Patterson | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-04-03 |
| 1174647945 | Angelique Berens | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-03-19 |
| 1144350448 | Johanna A Slob | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-03-06 |
| 1316075617 | April Netzer | Marriage & Family Therapist | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396826 | Family Matters of Marin | Community/Behavioral Health | 1346 4th St Ste 202, San Rafael, CA 94901-2860 | 2019-09-25 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| 1144687302 | Ritter Center | Community/Behavioral Health | 190 Mill St, Dining Room, San Rafael, CA 94901-4021 | 2016-01-19 |
| 1619362662 | Center Point, Inc. | Community/Behavioral Health | 199 Mill St., San Rafael, CA 94901 | 2015-04-06 |
| 1902204597 | Dba Nancy Freitas Lambert Psyd | Community/Behavioral Health | 1330 Lincoln Ave Ste 102b, San Rafael, CA 94901-2141 | 2014-12-12 |
| 1669878765 | Seneca Family of Agencies | Community/Behavioral Health | 25 W Castlewood Dr, San Rafael, CA 94901-2538 | 2014-11-17 |
| 1396141198 | Seneca Family of Agencies | Community/Behavioral Health | 177 N San Pedro Rd, San Rafael, CA 94903-4200 | 2014-11-06 |
| 1376957373 | Shana Gaviglio Kenney | Community/Behavioral Health | 1665 Grand Ave, San Rafael, CA 94901-2211 | 2014-06-17 |
| 1104256411 | John Hamel & Associates | Community/Behavioral Health | 28 Upper Oak Dr, San Rafael, CA 94903-1732 | 2013-11-22 |
| 1093073876 | Bay Area Community Resources, Inc | Community/Behavioral Health | 3240 Kerner Blvd, San Rafael, CA 94901-4840 | 2012-04-30 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on CHILD THERAPY INSTITUTE OF MARIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.