Provider Demographics
NPI:1174386437
Name:CHILDS FAMILY THERAPY INC
Entity type:Organization
Organization Name:CHILDS FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:858-224-2658
Mailing Address - Street 1:4455 MURPHY CANYON RD STE 100-67
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4379
Mailing Address - Country:US
Mailing Address - Phone:858-224-2658
Mailing Address - Fax:858-723-7475
Practice Address - Street 1:4455 MURPHY CANYON RD STE 100-67
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4379
Practice Address - Country:US
Practice Address - Phone:858-224-2658
Practice Address - Fax:858-723-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty