Provider Demographics
NPI:1477971810
Name:THERAPEUTIC SOLUTION COUNSELING CENTER
Entity Type:Organization
Organization Name:THERAPEUTIC SOLUTION COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-915-4998
Mailing Address - Street 1:PO BOX 401486
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1486
Mailing Address - Country:US
Mailing Address - Phone:760-244-8188
Mailing Address - Fax:760-244-8099
Practice Address - Street 1:16377 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3567
Practice Address - Country:US
Practice Address - Phone:760-244-8188
Practice Address - Fax:760-244-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL48090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty