Provider Demographics
NPI:1689345001
Name:CHILD AND FAMILY COUNSELING CENTER PC
Entity Type:Organization
Organization Name:CHILD AND FAMILY COUNSELING CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CIRCE
Authorized Official - Middle Name:
Authorized Official - Last Name:VON HAUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:626-676-1447
Mailing Address - Street 1:38121 25TH ST E APT H104
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1529 E PALMDALE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2030
Practice Address - Country:US
Practice Address - Phone:626-676-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)