Provider Demographics
NPI:1649526484
Name:WEST VALLEY COUNSELING CENTER
Entity type:Organization
Organization Name:WEST VALLEY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR CLINICAL SUPERVI
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MFT
Authorized Official - Phone:818-758-9450
Mailing Address - Street 1:19634 VENTURA BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2966
Mailing Address - Country:US
Mailing Address - Phone:818-758-9450
Mailing Address - Fax:
Practice Address - Street 1:19634 VENTURA BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2966
Practice Address - Country:US
Practice Address - Phone:818-758-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST VALLEY COUNSELING CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-31
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16203251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health