Provider Demographics
NPI:1720803174
Name:SEVEN DUCKS THERAPY
Entity type:Organization
Organization Name:SEVEN DUCKS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:DECKER
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:574-551-0710
Mailing Address - Street 1:6718 VAN NOORD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1105
Mailing Address - Country:US
Mailing Address - Phone:574-551-0710
Mailing Address - Fax:
Practice Address - Street 1:6718 VAN NOORD AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1105
Practice Address - Country:US
Practice Address - Phone:574-551-0710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health