Individual provider · NPI-1

Marianna Klebanov, MFT and LPCC

Marriage & Family Therapist · San Carlos, CA

NPI number1942973805
StatusActive
Last updated in NPPESJun 12, 2025

Details

NPI
1942973805
Entity type
Individual (NPI-1)
Name
Marianna Klebanov
Credential
MFT and LPCC
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 27, 2021
Certification date
Jun 12, 2025
Last updated
Jun 12, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106H00000X Marriage & Family Therapist138005CAYes
101YM0800X Counselor, Mental Health––
101YM0800X Counselor, Mental Health13413CA
106H00000X Marriage & Family Therapist––
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Practice location

1303 San Carlos Ave
San Carlos, CA 94070-2317

Phone 650-425-3644

Mailing address

605 Middlefield Rd
Redwood City, CA 94063-1625

Phone 650-425-3644

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