Provider Demographics
NPI:1841609567
Name:BEVERLY HILLS PROFESSIONAL CLINICAL COUNSELOR INC
Entity Type:Organization
Organization Name:BEVERLY HILLS PROFESSIONAL CLINICAL COUNSELOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADLER OZAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:310-464-5226
Mailing Address - Street 1:6399 WILSHIRE BLVD STE 1021
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5713
Mailing Address - Country:US
Mailing Address - Phone:310-464-5226
Mailing Address - Fax:
Practice Address - Street 1:6399 WILSHIRE BLVD STE 1021
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5713
Practice Address - Country:US
Practice Address - Phone:310-464-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health