Provider Demographics
NPI:1154917235
Name:KRUG AND PARK FAMILY COUNSELING P.C.
Entity type:Organization
Organization Name:KRUG AND PARK FAMILY COUNSELING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:858-342-0501
Mailing Address - Street 1:PO BOX 711742
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92072-1742
Mailing Address - Country:US
Mailing Address - Phone:858-342-0501
Mailing Address - Fax:
Practice Address - Street 1:10800 WOODSIDE AVE SPC 46
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3152
Practice Address - Country:US
Practice Address - Phone:619-353-0818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty