Provider Demographics
NPI:1033631718
Name:SOCO DBT
Entity Type:Organization
Organization Name:SOCO DBT
Other - Org Name:SOCO DBT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CEDS
Authorized Official - Phone:949-524-1509
Mailing Address - Street 1:1001 DOVE ST STE 215
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2848
Mailing Address - Country:US
Mailing Address - Phone:949-524-1509
Mailing Address - Fax:
Practice Address - Street 1:1001 DOVE ST STE 215
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-524-1509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization