Provider Demographics
NPI:1336820190
Name:MK COUNSELING
Entity Type:Organization
Organization Name:MK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIEKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:657-214-0087
Mailing Address - Street 1:5500 E ATHERTON ST STE 227B
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4018
Mailing Address - Country:US
Mailing Address - Phone:657-214-0087
Mailing Address - Fax:
Practice Address - Street 1:5500 E ATHERTON ST STE 227B
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4018
Practice Address - Country:US
Practice Address - Phone:657-214-0087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIEKA K BLEDSOE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty