Provider Demographics
NPI:1720463037
Name:NOVELL & NOVELL COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:NOVELL & NOVELL COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT, LPCC
Authorized Official - Phone:951-694-0695
Mailing Address - Street 1:29748 RANCHO CALIFORNIA RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5286
Mailing Address - Country:US
Mailing Address - Phone:951-694-0695
Mailing Address - Fax:951-695-6215
Practice Address - Street 1:3150 CASE RD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-5551
Practice Address - Country:US
Practice Address - Phone:951-694-0695
Practice Address - Fax:951-695-6215
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVELL & NOVELL COUNSELLING SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty