Provider Demographics
NPI:1972140432
Name:OAK AND STONE MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:OAK AND STONE MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HATTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:213-394-6404
Mailing Address - Street 1:5619 NORTH FIGUEROA STREET
Mailing Address - Street 2:#212
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042
Mailing Address - Country:US
Mailing Address - Phone:213-394-6404
Mailing Address - Fax:
Practice Address - Street 1:5619 NORTH FIGUEROA STREET
Practice Address - Street 2:#212
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042
Practice Address - Country:US
Practice Address - Phone:213-394-6404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty