Provider Demographics
NPI:1700126240
Name:BUILDING FOUNDATIONS COUNSELING CENTER
Entity Type:Organization
Organization Name:BUILDING FOUNDATIONS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-988-5531
Mailing Address - Street 1:193 BLUE RAVINE RD
Mailing Address - Street 2:SUITE #220
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4756
Mailing Address - Country:US
Mailing Address - Phone:916-988-5531
Mailing Address - Fax:916-987-9749
Practice Address - Street 1:193 BLUE RAVINE RD
Practice Address - Street 2:SUITE #220
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4756
Practice Address - Country:US
Practice Address - Phone:916-988-5531
Practice Address - Fax:916-987-9749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35315251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health