Provider Demographics
NPI:1760202741
Name:HERBERT HEALING MARRIAGE AND FAMILY COUNSELING, PROFESSIONAL
Entity type:Organization
Organization Name:HERBERT HEALING MARRIAGE AND FAMILY COUNSELING, PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-269-9617
Mailing Address - Street 1:638 AWAAL ST
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-2779
Mailing Address - Country:US
Mailing Address - Phone:951-269-9617
Mailing Address - Fax:
Practice Address - Street 1:41593 WINCHESTER RD STE 150
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4860
Practice Address - Country:US
Practice Address - Phone:951-775-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty