Provider Demographics
NPI:1063910180
Name:RICK JOSEPH SCARPELLO
Entity type:Organization
Organization Name:RICK JOSEPH SCARPELLO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SCARPELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT #111512
Authorized Official - Phone:415-623-4601
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-0027
Mailing Address - Country:US
Mailing Address - Phone:415-623-4601
Mailing Address - Fax:
Practice Address - Street 1:7250 REDWOOD BLVD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3268
Practice Address - Country:US
Practice Address - Phone:415-638-2660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty