| Therapeutically Connected Family Counseling, Inc | |
|
12712 Heacock St Ste 3 Moreno Valley CA 92553-3037 | |
| (951) 550-0039 | |
| Not Available |
| Full Name | Therapeutically Connected Family Counseling, Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 12712 Heacock St Ste 3, Moreno Valley, California |
| Authorized Official Name and Position | Lanicee Causly (PRESIDENT) |
| Authorized Official Contact | 9515500039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutically Connected Family Counseling, Inc 12712 Heacock St Ste 3 Moreno Valley CA 92553-3037 Ph: (951) 550-0039 | Therapeutically Connected Family Counseling, Inc 12712 Heacock St Ste 3 Moreno Valley CA 92553-3037 Ph: (951) 550-0039 |
| NPI Number | 1992394738 |
|---|---|
| Provider Enumeration Date | 01/15/2021 |
| Last Update Date | 01/21/2024 |
| Certification Date | 01/21/2024 |
| Medicare PECOS PAC ID | 7719330471 |
|---|---|
| Medicare Enrollment ID | O20240129004121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992394738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Lanicee Causly |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376770339 PECOS PAC ID: 9537512298 Enrollment ID: I20240129004177 |
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