Provider Demographics
NPI:1346073848
Name:RELATIONSHIPS, A MARRIAGE, FAMILY THERAPY AND EDUCATIONAL PSYCHOLOGY
Entity type:Organization
Organization Name:RELATIONSHIPS, A MARRIAGE, FAMILY THERAPY AND EDUCATIONAL PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BETTENCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPCC, LEP
Authorized Official - Phone:408-415-0267
Mailing Address - Street 1:15425 OAK GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-8802
Mailing Address - Country:US
Mailing Address - Phone:408-203-4401
Mailing Address - Fax:408-351-0333
Practice Address - Street 1:605 TENNANT AVE STE G
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5529
Practice Address - Country:US
Practice Address - Phone:408-415-0267
Practice Address - Fax:408-321-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty