Provider Demographics
NPI:1003218181
Name:MANHATTAN VILLAGE COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:MANHATTAN VILLAGE COUNSELING CENTER, INC.
Other - Org Name:MANHATTAN VILLAGE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-545-4422
Mailing Address - Street 1:3201 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2463
Mailing Address - Country:US
Mailing Address - Phone:310-545-4422
Mailing Address - Fax:310-545-3322
Practice Address - Street 1:3201 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2463
Practice Address - Country:US
Practice Address - Phone:310-545-4422
Practice Address - Fax:310-545-3322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty