Provider Demographics
NPI:1982000485
Name:GLENN L ABRAMS MARRIAGE FAMILY & CHILD COUNSELING INC.
Entity Type:Organization
Organization Name:GLENN L ABRAMS MARRIAGE FAMILY & CHILD COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-718-9354
Mailing Address - Street 1:133 E BONITA AVE
Mailing Address - Street 2:STE. 205
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3173
Mailing Address - Country:US
Mailing Address - Phone:909-718-9354
Mailing Address - Fax:
Practice Address - Street 1:133 E BONITA AVE
Practice Address - Street 2:STE. 205
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3173
Practice Address - Country:US
Practice Address - Phone:909-718-9354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57325261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)