Provider Demographics
NPI:1861938722
Name:MERRELL FAMILY COUNSELING, INC.
Entity type:Organization
Organization Name:MERRELL FAMILY COUNSELING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-218-0951
Mailing Address - Street 1:7365 CARNELIAN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1136
Mailing Address - Country:US
Mailing Address - Phone:909-281-1557
Mailing Address - Fax:877-850-5695
Practice Address - Street 1:7365 CARNELIAN ST STE 240
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1136
Practice Address - Country:US
Practice Address - Phone:909-281-1557
Practice Address - Fax:877-850-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty