Provider Demographics
NPI:1922353622
Name:QUALITY COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:QUALITY COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BSW, M.SC
Authorized Official - Prefix:
Authorized Official - First Name:RACHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEJJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-415-8267
Mailing Address - Street 1:10828 COLDWATER ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1241
Mailing Address - Country:US
Mailing Address - Phone:260-415-8267
Mailing Address - Fax:
Practice Address - Street 1:10828 COLDWATER ROAD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1241
Practice Address - Country:US
Practice Address - Phone:260-415-8267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty