Provider Demographics
NPI:1861749764
Name:TEAM 3 FAMILY COUNSELING CENTER
Entity type:Organization
Organization Name:TEAM 3 FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-478-5701
Mailing Address - Street 1:400 HOOVER LN
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2944
Mailing Address - Country:US
Mailing Address - Phone:530-478-5701
Mailing Address - Fax:530-478-5703
Practice Address - Street 1:400 HOOVER LN
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2944
Practice Address - Country:US
Practice Address - Phone:530-478-5701
Practice Address - Fax:530-478-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 7779251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health