Provider Demographics
NPI:1376340331
Name:RO MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:RO MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:858-208-0189
Mailing Address - Street 1:3240 LAKEVIEW DR
Mailing Address - Street 2:BOX 233
Mailing Address - City:JULIAN
Mailing Address - State:CA
Mailing Address - Zip Code:92036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3240 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:CA
Practice Address - Zip Code:92036
Practice Address - Country:US
Practice Address - Phone:619-962-7921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)