| Olive Leaf Family Therapy, Inc | |
|
6276 N 1st St Ste 103 Fresno CA 93710-5400 | |
| (559) 712-4300 | |
| (559) 412-2104 |
| Full Name | Olive Leaf Family Therapy, Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 6276 N 1st St Ste 103, Fresno, California |
| Authorized Official Name and Position | Laura Alice Slagle (CEO, CLINICAL DIRECTOR) |
| Authorized Official Contact | 5599708831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Leaf Family Therapy, Inc 6276 N 1st St Ste 103 Fresno CA 93710-5400 Ph: (559) 712-4300 | Olive Leaf Family Therapy, Inc 6276 N 1st St Ste 103 Fresno CA 93710-5400 Ph: (559) 712-4300 |
| NPI Number | 1447816079 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 10/29/2019 |
| Medicare PECOS PAC ID | 7810428851 |
|---|---|
| Medicare Enrollment ID | O20241002000768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447816079 | NPI | - | NPPES |
| 83605 | Other | CA | CA BOARD OF BEHAVIORAL SCIENCES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Eliana Romero |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1821446626 PECOS PAC ID: 8527502871 Enrollment ID: I20240627003911 |
| Provider Name | Laura Alice Slagle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922255199 PECOS PAC ID: 2365973302 Enrollment ID: I20241002000913 |
| Provider Name | Sarah Ashley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1043895436 PECOS PAC ID: 4284165234 Enrollment ID: I20241002001139 |
| Provider Name | Alexandra Antonia Garcia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407491483 PECOS PAC ID: 6709317654 Enrollment ID: I20241002001319 |
| Provider Name | Alexis Burger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992344097 PECOS PAC ID: 1951832807 Enrollment ID: I20241002001420 |
| Provider Name | Mallory Lewis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1417583279 PECOS PAC ID: 0345772505 Enrollment ID: I20241014002471 |
| Provider Name | Cheryl Anne Hixson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306398805 PECOS PAC ID: 4183155120 Enrollment ID: I20241211002526 |
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Fresno County California Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 Van Ness Ave, Fresno, CA 93721 Phone: 559-488-1318 |