Provider Demographics
NPI:1740827815
Name:HEALING CLINICAL COUNSELING CENTER, INC
Entity type:Organization
Organization Name:HEALING CLINICAL COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:323-487-3736
Mailing Address - Street 1:221 S. FIGUEROA ST STE 310, OFFICE J
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3759
Mailing Address - Country:US
Mailing Address - Phone:562-507-1616
Mailing Address - Fax:213-260-8586
Practice Address - Street 1:221 S FIGUEROA ST STE 310
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3759
Practice Address - Country:US
Practice Address - Phone:562-507-1616
Practice Address - Fax:213-260-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-07
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty