Provider Demographics
NPI:1699444364
Name:SARAH JANE CELLA, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Entity type:Organization
Organization Name:SARAH JANE CELLA, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-216-4020
Mailing Address - Street 1:1113 1/2 CABRILLO AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-5264
Mailing Address - Country:US
Mailing Address - Phone:203-216-4020
Mailing Address - Fax:
Practice Address - Street 1:4620 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5408
Practice Address - Country:US
Practice Address - Phone:203-216-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1255725362OtherNPI INDIVIDUAL