Provider Demographics
NPI:1396990362
Name:SCION COUNSELING LLC
Entity type:Organization
Organization Name:SCION COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:760-609-0808
Mailing Address - Street 1:PO BOX 6331
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-6331
Mailing Address - Country:US
Mailing Address - Phone:760-609-0808
Mailing Address - Fax:760-609-0808
Practice Address - Street 1:43585 MONTEREY AVE.
Practice Address - Street 2:SUITE 4
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-9398
Practice Address - Country:US
Practice Address - Phone:760-609-0808
Practice Address - Fax:760-609-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC 25251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health