Doctor Name: | MR. GEORGE LAWRENCE THEISEN |
NPI Number: | 1285882092 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MFT |
License Number: | MFC 41555 |
Business Practice Address: | 1911 Commercenter E Suite 101 San Bernardino, CA - 924083454 |
Business Phone Number: | 9093813579 |
Business Fax Number: | 9093813501 |
Mailing Address: | Po Box 3544, CRESTLINE |
State: | CA |
Postal Code: | 923253544 |
Phone Number: | 9096459601 |
Fax Number: | 9093813501 |
NPI Enumeration Date: | 09/04/2008 |
NPI Last Update Date: | 05/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 106H00000X |
License Number: | MFC 41555 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Marriage & Family Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |