Provider Demographics
NPI:1902601198
Name:NORTH BAY YOUTH AND FAMILY COUNSELING, INC.
Entity type:Organization
Organization Name:NORTH BAY YOUTH AND FAMILY COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:NERSESIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:707-595-8161
Mailing Address - Street 1:8733 LAKEWOOD DR STE 205
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-9554
Mailing Address - Country:US
Mailing Address - Phone:707-595-8161
Mailing Address - Fax:
Practice Address - Street 1:8733 LAKEWOOD DR STE 205
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-9554
Practice Address - Country:US
Practice Address - Phone:707-329-5707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH BAY YOUTH AND FAMILY COUNSELING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty