Provider Demographics
NPI:1205895364
Name:KINGS COUNSELING CENTER
Entity type:Organization
Organization Name:KINGS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR KINGS COUNSELING CENTER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:559-584-2819
Mailing Address - Street 1:808 N IRWIN STREET
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3838
Mailing Address - Country:US
Mailing Address - Phone:559-584-2819
Mailing Address - Fax:559-584-2820
Practice Address - Street 1:808 N IRWIN STREET
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3838
Practice Address - Country:US
Practice Address - Phone:559-584-2819
Practice Address - Fax:559-584-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36396106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty