Provider Demographics
NPI:1194190330
Name:VALIANT COUNSELING CENTER
Entity Type:Organization
Organization Name:VALIANT COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BONNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:916-765-1450
Mailing Address - Street 1:8146 GREENBACK LN
Mailing Address - Street 2:SUITE 103-D
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-2551
Mailing Address - Country:US
Mailing Address - Phone:916-765-1450
Mailing Address - Fax:
Practice Address - Street 1:8146 GREENBACK LN
Practice Address - Street 2:SUITE 103-D
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-2551
Practice Address - Country:US
Practice Address - Phone:916-765-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49354251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health