Provider Demographics
NPI:1134771447
Name:COUNSELING RESOURCE AND EDUCATION CENTER
Entity type:Organization
Organization Name:COUNSELING RESOURCE AND EDUCATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-310-9215
Mailing Address - Street 1:21151 S WESTERN AVE STE 146
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1724
Mailing Address - Country:US
Mailing Address - Phone:424-271-7778
Mailing Address - Fax:888-792-6665
Practice Address - Street 1:21151 S WESTERN AVE STE 146
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1724
Practice Address - Country:US
Practice Address - Phone:424-271-7778
Practice Address - Fax:888-792-6665
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANDRA FORTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB246247OtherMEDICARE
CA1265855118Medicaid