Provider Demographics
NPI:1346462082
Name:INTERCOMMUNITY COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:INTERCOMMUNITY COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERLE-ROMBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-698-1272
Mailing Address - Street 1:7702 WASHINGTON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2200
Mailing Address - Country:US
Mailing Address - Phone:562-698-1272
Mailing Address - Fax:562-698-1274
Practice Address - Street 1:7702 WASHINGTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2200
Practice Address - Country:US
Practice Address - Phone:562-698-1272
Practice Address - Fax:562-698-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty