Provider Demographics
NPI:1831282458
Name:COUNSELING CORNER, INC.
Entity Type:Organization
Organization Name:COUNSELING CORNER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:949-510-9423
Mailing Address - Street 1:2212 DUPONT DR.
Mailing Address - Street 2:SUITE I
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612
Mailing Address - Country:US
Mailing Address - Phone:949-510-9423
Mailing Address - Fax:949-916-2978
Practice Address - Street 1:2212 DUPONT DR.
Practice Address - Street 2:SUITE I
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612
Practice Address - Country:US
Practice Address - Phone:949-510-9423
Practice Address - Fax:949-916-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS21005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty