Provider Demographics
NPI:1023760691
Name:MK CONSULTING AND COUNSELING LLC
Entity type:Organization
Organization Name:MK CONSULTING AND COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMOLTHITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-265-8222
Mailing Address - Street 1:3865 GOLDEN MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-2635
Mailing Address - Country:US
Mailing Address - Phone:562-265-8222
Mailing Address - Fax:
Practice Address - Street 1:3865 GOLDEN MEADOW CT
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-2635
Practice Address - Country:US
Practice Address - Phone:562-265-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty