Individual provider · Type 1 NPI

Jackie A. Provencher, AMFT

Marriage & Family Therapist · Long Beach, CA

NPI number 1497397939 Active

Practice location

2211 E Ocean Blvd
Long Beach, CA 90803-2440

Call (562) 434-4060 Map

Mailing address

7025 E El Paseo St
Long Beach, CA 90815-3507

Specialties and licenses

TaxonomyCodeLicense
Marriage & Family Therapist Primary 106H00000X79380 (CA)

Marriage & Family Therapist: 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 ment…

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About NPI 1497397939

Jackie A. Provencher, AMFT's National Provider Identifier is 1497397939, issued on Oct 16, 2019. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in Long Beach, CA. The record was last updated on Oct 16, 2019.