Provider Demographics
NPI:1578291688
Name:GARNETT COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:GARNETT COUNSELING SERVICES, PC
Other - Org Name:GARNETT COUNSELING AND WELLNESS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:657-845-9667
Mailing Address - Street 1:302 S. MIRALESTE DRIVE
Mailing Address - Street 2:UNIT 18
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3020
Mailing Address - Country:US
Mailing Address - Phone:657-845-9667
Mailing Address - Fax:
Practice Address - Street 1:1164 183RD STREET
Practice Address - Street 2:#1164
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:888-427-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)