Provider Demographics
NPI:1134569288
Name:HORSE PLAY THERAPY
Entity type:Organization
Organization Name:HORSE PLAY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PSYD
Authorized Official - Phone:949-887-1612
Mailing Address - Street 1:18381 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1107
Mailing Address - Country:US
Mailing Address - Phone:949-887-1612
Mailing Address - Fax:714-842-7774
Practice Address - Street 1:18381 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1107
Practice Address - Country:US
Practice Address - Phone:949-887-1612
Practice Address - Fax:714-842-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS184211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty