Provider Demographics
NPI:1245604909
Name:SONOMA COUNTY COUNSELING
Entity Type:Organization
Organization Name:SONOMA COUNTY COUNSELING
Other - Org Name:PAUL MARGOLIS, LMFT, R-DMT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:707-322-1929
Mailing Address - Street 1:PO BOX 9591
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-1591
Mailing Address - Country:US
Mailing Address - Phone:707-322-1929
Mailing Address - Fax:707-540-0484
Practice Address - Street 1:3434 MENDOCINO AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2274
Practice Address - Country:US
Practice Address - Phone:707-322-1929
Practice Address - Fax:707-540-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT34259261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health