Provider Demographics
NPI:1780269233
Name:NASABA CHILDREN & FAMILY COUNSELING
Entity type:Organization
Organization Name:NASABA CHILDREN & FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-848-5266
Mailing Address - Street 1:506 S SPRING ST UNIT 13308
Mailing Address - Street 2:13024
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-3215
Mailing Address - Country:US
Mailing Address - Phone:310-848-5266
Mailing Address - Fax:
Practice Address - Street 1:506 S SPRING ST UNIT 13308
Practice Address - Street 2:13024
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-3215
Practice Address - Country:US
Practice Address - Phone:310-848-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)