Provider Demographics
NPI:1487894648
Name:STANSELL, CATHY (MFT)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:STANSELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 MOLINO AVE
Mailing Address - Street 2:7
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5740
Mailing Address - Country:US
Mailing Address - Phone:562-760-2168
Mailing Address - Fax:
Practice Address - Street 1:959 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-2207
Practice Address - Country:US
Practice Address - Phone:310-677-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist