Provider Demographics
NPI:1528411162
Name:ELEMENTS COUNSELING GROUP
Entity Type:Organization
Organization Name:ELEMENTS COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, MCA, CSC
Authorized Official - Phone:805-349-2255
Mailing Address - Street 1:301 S MILLER ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5205
Mailing Address - Country:US
Mailing Address - Phone:805-349-2255
Mailing Address - Fax:
Practice Address - Street 1:301 S MILLER ST
Practice Address - Street 2:SUITE 108
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5205
Practice Address - Country:US
Practice Address - Phone:805-349-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENTS COUNSELING GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X, 251B00000X, 251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty