Provider Demographics
NPI:1871642686
Name:AFFILIATED COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:AFFILIATED COUNSELING SERVICES, INC.
Other - Org Name:RISKIN-BANKER PSYCHOTHERAPY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TREGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:ESQUIRE
Authorized Official - Phone:714-848-5804
Mailing Address - Street 1:16152 BEACH BLVD
Mailing Address - Street 2:SUITE # 280
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3806
Mailing Address - Country:US
Mailing Address - Phone:714-848-5804
Mailing Address - Fax:714-848-5184
Practice Address - Street 1:16152 BEACH BLVD
Practice Address - Street 2:SUITE # 280
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3806
Practice Address - Country:US
Practice Address - Phone:714-848-5804
Practice Address - Fax:714-848-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT35346302R00000X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered302R00000XManaged Care OrganizationsHealth Maintenance Organization
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization