Provider Demographics
NPI:1245318500
Name:BEJARANO COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:BEJARANO COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEJARANO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:520-313-3476
Mailing Address - Street 1:1790 N MASTICK WAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-1135
Mailing Address - Country:US
Mailing Address - Phone:520-313-3476
Mailing Address - Fax:520-377-8279
Practice Address - Street 1:1790 N MASTICK WAY
Practice Address - Street 2:SUITE D
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1135
Practice Address - Country:US
Practice Address - Phone:520-313-3476
Practice Address - Fax:520-377-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty