Provider Demographics
NPI:1194182048
Name:AFFINITE COMMUNITY COUNSELING AGENCY
Entity Type:Organization
Organization Name:AFFINITE COMMUNITY COUNSELING AGENCY
Other - Org Name:BRANDY JONES-THOMAS
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/LEAD CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, MA
Authorized Official - Phone:916-599-9696
Mailing Address - Street 1:9245 LAGUNA SPRINGS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7987
Mailing Address - Country:US
Mailing Address - Phone:916-661-1564
Mailing Address - Fax:
Practice Address - Street 1:9245 LAGUNA SPRINGS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7987
Practice Address - Country:US
Practice Address - Phone:916-661-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-23
Last Update Date:2016-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82210251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health