Provider Demographics
NPI:1609327667
Name:PSYCHHEALING COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:PSYCHHEALING COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NHUNG
Authorized Official - Middle Name:TUYET
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-683-2945
Mailing Address - Street 1:1011 N BEGONIA AVE STE 1009
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-2104
Mailing Address - Country:US
Mailing Address - Phone:800-683-2945
Mailing Address - Fax:
Practice Address - Street 1:1011 N BEGONIA AVE STE 1009
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2104
Practice Address - Country:US
Practice Address - Phone:800-683-2945
Practice Address - Fax:909-906-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 103TC0700X
CAPSY28271103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty