Provider Demographics
NPI:1487296018
Name:JUSTIN NATOLI, LICENSED MARRIAGE AND FAMILY THERAPIST INC.
Entity type:Organization
Organization Name:JUSTIN NATOLI, LICENSED MARRIAGE AND FAMILY THERAPIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATOLI
Authorized Official - Suffix:
Authorized Official - Credentials:JD, LMFT
Authorized Official - Phone:310-508-2590
Mailing Address - Street 1:4020 OLMSTED AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-2628
Mailing Address - Country:US
Mailing Address - Phone:310-508-2590
Mailing Address - Fax:
Practice Address - Street 1:4020 OLMSTED AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-2628
Practice Address - Country:US
Practice Address - Phone:310-508-2590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty