| Mycelium Family Therapy, Professional Corporation | |
|
1500 Valley House Dr Ste 210 Rohnert Park CA 94928-4938 | |
| (707) 782-2419 | |
| (707) 715-2875 |
| Full Name | Mycelium Family Therapy, Professional Corporation |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1500 Valley House Dr Ste 210, Rohnert Park, California |
| Authorized Official Name and Position | Lacey Lynn Palmer (PRESIDENT, CEO) |
| Authorized Official Contact | 7077822419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mycelium Family Therapy, Professional Corporation 1500 Valley House Dr Ste 210 Rohnert Park CA 94928-4938 Ph: (707) 782-2419 | Mycelium Family Therapy, Professional Corporation 1500 Valley House Dr Ste 210 Rohnert Park CA 94928-4938 Ph: (707) 782-2419 |
| NPI Number | 1124957030 |
|---|---|
| Provider Enumeration Date | 05/16/2026 |
| Last Update Date | 07/10/2026 |
| Certification Date | 07/10/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124957030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Lifeworks Of Sonoma County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5450 Snyder Lane, Rohnert Park, CA 94928 Phone: 707-792-6506 Fax: 707-792-4758 | |
Lifeworks Of Sonoma County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5154 Snyder Lane, Rohnert Park, CA 94928 Phone: 707-585-6283 Fax: 707-588-5607 | |
Turning Point Community Programs Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 967 Golf Course Dr, Rohnert Park, CA 94928 Phone: 916-364-8395 | |
Anka Behavorial Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1033 San Francisco Way, Rohnert Park, CA 94928 Phone: 707-586-9480 | |
Homefirst Services Of Santa Clara County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6050 Labath Ave, Rohnert Park, CA 94928 Phone: 408-206-6710 Fax: 408-957-0253 | |
California Parenting Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7345 Burton Ave, Rohnert Park, CA 94928 Phone: 707-585-6108 Fax: 707-585-6155 |