Provider Demographics
NPI:1598101297
Name:COUNSELING & BEHAVIORAL SPECIALSTS, MARRIAGE, FAMILY, CHILD COUNSELING
Entity Type:Organization
Organization Name:COUNSELING & BEHAVIORAL SPECIALSTS, MARRIAGE, FAMILY, CHILD COUNSELING
Other - Org Name:COUNSELING & BEHAVIORAL SPECIALISTS, MFCC INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-697-0470
Mailing Address - Street 1:4700 SPRING ST
Mailing Address - Street 2:STE 203
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0263
Mailing Address - Country:US
Mailing Address - Phone:619-697-0470
Mailing Address - Fax:619-697-0505
Practice Address - Street 1:4700 SPRING ST
Practice Address - Street 2:STE 203
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0263
Practice Address - Country:US
Practice Address - Phone:619-697-0470
Practice Address - Fax:619-697-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health