CHILD THERAPY INSTITUTE OF MARIN (NPI# 1760891931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760891931 |
| Entity Type | Organization |
| Organization Name | CHILD THERAPY INSTITUTE OF MARIN |
| Other Organization Name | WASHINGTON ELEMENTARY SCHOOL |
| Practice Address |
2300 Martin Luther King Jr Way, Resource Room Berkeley CA 94704-1412 |
| Mailing Address |
1480 Lincoln Ave Ste 8 San Rafael CA 94901-2085 |
| Practice Telephone | 5106446310 |
| Mailing Telephone | 4154567724 |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2017-11-16 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Washington Elementary School | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1619014081 | Child Therapy Institute of Marin | Clinic/Center | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-02-01 |
| 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 |
2300 MARTIN LUTHER KING JR WAY, RESOURCE ROOM |
| City | BERKELEY |
| State | CA |
| Zip Code | 94704-1412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1821617168 | Michelle Nagal Hunt | Behavior Technician | 2080 Addison Street, #302, Berkeley, CA 94704 | 2020-04-15 |
| 1366097081 | Sabrina Barnett | Behavior Technician | 2080 Addison St, #302, Berkeley, CA 94704 | 2019-08-08 |
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1376014928 | Justin T Cooke | Specialist/Technologist | 2024 Durant Ave #508, Berkeley, CA 94704 | 2018-12-07 |
| 1972080158 | Cecilia Winfield | Student in an Organized Health Care Education/Training Program | 1918 University Ave., Suite 2b, Berkeley, CA 94704 | 2018-07-20 |
| 1952897332 | Jennifer Henry Henry | Naturopath | 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 | 2018-07-09 |
| 1497267967 | Merlenet Michelle Riley | Counselor | 2640 Martin Luther King, Berkeley, CA 94704 | 2017-10-24 |
| 1265951719 | Caitlin Mary Mcdonough | Student in an Organized Health Care Education/Training Program | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-09-15 |
| 1922525120 | Patrice Werling | Counselor | 1918 University Avenue, Suite 2b, Berkeley, CA 94704 | 2017-08-28 |
| Find all providers in zip 94704 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952950461 | City of Berkeley | Clinic/Center | 1980 Allston Way Ste H105, Berkeley, CA 94704-1463 | 2019-09-06 |
| 1386261436 | Lara Benefield, Lmft | Clinic/Center | 2915 Martin Luther King Jr Way, Berkeley, CA 94703-2133 | 2020-07-05 |
| 1851833784 | City of Berkeley | Clinic/Center | 1521 University Ave, Berkeley, CA 94703-1422 | 2016-11-09 |
| 1710429642 | City of Berkeley | Clinic/Center | 1890 Alcatraz Ave, Berkeley, CA 94703-2715 | 2016-11-09 |
| 1043434095 | Pacific Center for Human Growth | Clinic/Center | 2712 Telegraph Ave, Berkeley, CA 94705-1117 | 2007-04-12 |
| 1215963699 | City of Berkeley | Clinic/Center | 2640 Martin Luther King Jr Way, Berkeley, CA 94704-3238 | 2006-06-25 |
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| 1184238875 | Integrative Psychotherapy Group, A Marriage and Family Therapy Corp | Clinic/Center | 311 N Robertson Blvd Ste 718, Beverly Hills, CA 90211-1705 | 2020-09-01 |
| 1962016527 | Los Angeles County Department of Mental Health | Clinic/Center | 2934 E Garvey Ave South Ste 230, West Covina, CA 91791-6101 | 2020-09-01 |
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| Find all providers with the same taxonomy | ||||
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| 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.