Provider Demographics
NPI:1508402363
Name:COLDWATER COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:COLDWATER COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIPEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-508-0703
Mailing Address - Street 1:20301 VENTURA BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0932
Mailing Address - Country:US
Mailing Address - Phone:818-508-0703
Mailing Address - Fax:
Practice Address - Street 1:4419 COLDWATER CANYON AVE STE E
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1478
Practice Address - Country:US
Practice Address - Phone:818-508-0703
Practice Address - Fax:818-508-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty