Provider Demographics
NPI:1659555902
Name:VILLAGE COUNSELING
Entity Type:Organization
Organization Name:VILLAGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-773-0669
Mailing Address - Street 1:73302 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3904
Mailing Address - Country:US
Mailing Address - Phone:760-773-0669
Mailing Address - Fax:760-773-0569
Practice Address - Street 1:51800 HARRISON ST
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1500
Practice Address - Country:US
Practice Address - Phone:760-398-8055
Practice Address - Fax:760-398-8766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT14133101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty