Provider Demographics
NPI:1427734573
Name:SELF HARMONY INDIVIDUAL AND FAMILY THERAPY
Entity type:Organization
Organization Name:SELF HARMONY INDIVIDUAL AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, BCBA
Authorized Official - Phone:510-974-1987
Mailing Address - Street 1:3021 TELEGRAPH AVE STE C3
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2072
Mailing Address - Country:US
Mailing Address - Phone:510-974-1987
Mailing Address - Fax:
Practice Address - Street 1:3021 TELEGRAPH AVE STE C3
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2072
Practice Address - Country:US
Practice Address - Phone:510-974-1987
Practice Address - Fax:925-665-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty