Provider Demographics
NPI:1083594451
Name:HEALING WATERS MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:HEALING WATERS MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGROVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-874-7851
Mailing Address - Street 1:16031 TUSCOLA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1319
Mailing Address - Country:US
Mailing Address - Phone:661-463-0506
Mailing Address - Fax:661-524-9950
Practice Address - Street 1:16031 TUSCOLA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1319
Practice Address - Country:US
Practice Address - Phone:661-463-0506
Practice Address - Fax:661-524-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty