Provider Demographics
NPI:1912562877
Name:INSIDE OUT COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:INSIDE OUT COUNSELING SERVICES INC
Other - Org Name:INSIDE OUT COUNSELING SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA NELY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:949-463-4949
Mailing Address - Street 1:2522 CHAMBERS RD STE 125
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6962
Mailing Address - Country:US
Mailing Address - Phone:949-463-4949
Mailing Address - Fax:
Practice Address - Street 1:2522 CHAMBERS RD STE 125
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6962
Practice Address - Country:US
Practice Address - Phone:949-463-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty