CHILD THERAPY INSTITUTE OF MARIN (NPI# 1790216489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790216489 |
| Entity Type | Organization |
| Organization Name | CHILD THERAPY INSTITUTE OF MARIN |
| Practice Address |
240 Tamal Vista Blvd #155 Corte Madera CA 94925-1132 |
| Mailing Address |
1480 Lincoln Ave #8 San Rafael CA 94901-2084 |
| Practice Telephone | 4154567724 |
| Practice Fax Number | 4154561050 |
| Mailing Telephone | 4154567724 |
| Mailing Fax Number | 4154561050 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |
| Authorized Official Name | 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 | 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 |
| 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 |
| 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 |
240 TAMAL VISTA BLVD #155 |
| City | CORTE MADERA |
| State | CA |
| Zip Code | 94925-1132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396753232 | Charles S Fleckles | Psychiatry & Neurology | 240 Tamal Vista Blvd, Suite 162, Corte Madera, CA 94925 | 2006-08-04 |
| 1326279183 | Catherine E. Main, Inc. | Psychologist | 240 Tamal Vista Blvd, Suite 270, Corte Madera, CA 94925-1132 | 2009-07-28 |
| 1962633701 | Catherine Elizabeth Main | Psychologist | 240 Tamal Vista Blvd, Suite 270, Corte Madera, CA 94925-1132 | 2009-07-28 |
| 1780813550 | Naomi Butler | Marriage & Family Therapist | 240 Tamal Vista Blvd, Suite 270, Corte Madera, CA 94925-1132 | 2009-07-14 |
| 1417196023 | Marilla Waesche Pivonka | Marriage & Family Therapist | 240 Tamal Vista Blvd, Ste 290, Corte Madera, CA 94925-1159 | 2009-02-05 |
| 1124276050 | Lynn Mcleod | Marriage & Family Therapist | 240 Tamal Vista Blvd, Suite 162, Corte Madera, CA 94925-1132 | 2008-09-04 |
| 1194998047 | Jacqueline May Ladrech | Counselor | 240 Tamal Vista Blvd, Suite 270, Corte Madera, CA 94925-1132 | 2008-04-10 |
| 1891998449 | Indrojit Singh | Psychologist | 240 Tamal Vista Blvd, Ste #180, Corte Madera, CA 94925 | 2007-06-08 |
| 1164545141 | Esther G Stone | Social Worker | 240 Tamal Vista Blvd, #290, Corte Madera, CA 94925-1132 | 2007-04-06 |
| 1669502183 | Ernest Troy Bryant | Clinical Neuropsychologist | 240 Tamal Vista Blvd, Corte Madera, CA 94925-1132 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386139061 | California Center for Ms and Neurology Inc | Psychiatry & Neurology | 21 Tamal Vista Blvd Ste 175, Corte Madera, CA 94925 | 2018-06-26 |
| 1982130514 | Summer Nipomnick | Psychologist | 200 Tamal Plaza, Suite 235, Corte Madera, CA 94925 | 2017-05-02 |
| 1376784561 | Marcie Morton | Chiropractor | 2 Fifer Ave Ste 130, Corte Madera, CA 94925 | 2009-03-17 |
| 1154598365 | Kristine Kay Twite Lehnen | Registered Nurse | 42 Creekside Ct, Corte Madera, CA 94925 | 2008-05-15 |
| 1811163884 | Susan Mary Nickerson | Nurse Anesthetist, Certified Registered | 239 Koch Rd, Corte Madera, CA 94925 | 2008-04-30 |
| 1225150485 | Noreen P Dunnigan | Marriage & Family Therapist | 200 Tamal Plaza, Ste 135, Corte Madera, CA 94925 | 2007-04-06 |
| 1356477889 | Rochelle L Teising | Marriage & Family Therapist | 100 Tamal Vista, #160, Corte Madera, CA 94925 | 2007-02-26 |
| 1518019181 | Lynne Harris | Psychologist | 100 Tamal Plaza, Suite 108, Corte Madera, CA 94925 | 2007-01-17 |
| 1801975032 | Julie B Young | Dentist | 81 Casa Buena, Suite 6, Corte Madera, CA 94925 | 2006-11-06 |
| 1033294020 | Ann Margaret O'hare | Internal Medicine | 155 Golden Hind Passage, Corte Madera, CA 94925 | 2006-10-26 |
| Find all providers in zip 94925 | ||||
| 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 |
|---|---|---|---|---|
| 1942332077 | Stanislaus County | Community/Behavioral Health | 5725 Paradise Dr, Corte Madera, CA 94925-1212 | 2007-03-12 |
| 1770019317 | Nutreur LLC | Community/Behavioral Health | 770 Tamalpais Dr, Suite 206, Corte Madera, CA 94925-1700 | 2017-05-02 |
| 1043745482 | Lisa Murphy Lcsw | Community/Behavioral Health | 200 Tamal Plz, Ste 130, Corte Madera, CA 94925-1128 | 2017-04-24 |
| 1720406457 | Steps To Freedom | Community/Behavioral Health | 21 Tamal Vista Blvd, Suite 226, Corte Madera, CA 94925-1130 | 2014-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881861 | Griselda Tuchan Pineda Marriage and Family Therapist Inc | Community/Behavioral Health | 2820 S Vermont Ave Ste 16, Los Angeles, CA 90007-2291 | 2020-11-04 |
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1588264113 | Licensed Clinical Social Worker Community Alliance PC | Community/Behavioral Health | 301 S 23rd St, Richmond, CA 94804-2807 | 2020-11-01 |
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1891395232 | Jacqulyn Danielle Rios | Community/Behavioral Health | 4604 W Douglas Ave Apt 103, Visalia, CA 93291-4195 | 2020-10-26 |
| 1346849213 | Greystone Behavioral Health Nursing Inc | Community/Behavioral Health | 231 E Alessandro Blvd Ste A438, Riverside, CA 92508-5084 | 2020-10-22 |
| 1376142216 | Melissa Reyes Aguilar | Community/Behavioral Health | 2248 S Cochran Ave, Los Angeles, CA 90016-1218 | 2020-10-21 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1326647686 | Sierra Child & Family Services | Community/Behavioral Health | 564 Mountain Ranch Rd Ste 5, San Andreas, CA 95249-9782 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
| City | CORTE MADERA |
| Zip Code | 94925 |
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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.