Provider Demographics
NPI:1710740550
Name:GOOD VIBES COUNSELING
Entity Type:Organization
Organization Name:GOOD VIBES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-339-1822
Mailing Address - Street 1:1120 2ND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2230
Mailing Address - Country:US
Mailing Address - Phone:925-339-1822
Mailing Address - Fax:
Practice Address - Street 1:1120 2ND ST STE 110
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2230
Practice Address - Country:US
Practice Address - Phone:925-339-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty