Provider Demographics
NPI:1134780505
Name:CARING CONSISTENCY COUNSELING AND MENTAL HEALTH SERVICES LCSW, INC.
Entity type:Organization
Organization Name:CARING CONSISTENCY COUNSELING AND MENTAL HEALTH SERVICES LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:RAND
Authorized Official - Last Name:MACADAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:951-241-5084
Mailing Address - Street 1:3681 SUNNYSIDE DR # 2943
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2415
Mailing Address - Country:US
Mailing Address - Phone:951-241-5084
Mailing Address - Fax:
Practice Address - Street 1:6809 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4221
Practice Address - Country:US
Practice Address - Phone:951-241-5084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty