| Sea Change Psychotherapy Incorporated | |
|
164 Donahue St Sausalito CA 94965 | |
| (415) 967-2025 | |
| Not Available |
| Full Name | Sea Change Psychotherapy Incorporated |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 164 Donahue St, Sausalito, California |
| Authorized Official Name and Position | Tara L Kline (PRESIDENT AD CEO) |
| Authorized Official Contact | 4159672025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Change Psychotherapy Incorporated 203 Flamingo Rd #209 Mill Valley CA 94941-4149 Ph: (415) 987-1187 | Sea Change Psychotherapy Incorporated 164 Donahue St Sausalito CA 94965 Ph: (415) 967-2025 |
| NPI Number | 1568185619 |
|---|---|
| Provider Enumeration Date | 09/23/2022 |
| Last Update Date | 09/23/2022 |
| Certification Date | 09/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568185619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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