Provider Demographics
NPI:1861920753
Name:CONNECTED SEEN & HEARD MARRIAGE & FAMILY THERAPY CORPORATION
Entity type:Organization
Organization Name:CONNECTED SEEN & HEARD MARRIAGE & FAMILY THERAPY CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOST
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LMFT
Authorized Official - Phone:858-750-9016
Mailing Address - Street 1:1307 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2327
Mailing Address - Country:US
Mailing Address - Phone:858-750-9016
Mailing Address - Fax:
Practice Address - Street 1:1307 STRATFORD CT
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2327
Practice Address - Country:US
Practice Address - Phone:858-750-9016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty