Provider Demographics
NPI:1821800178
Name:PAS COUNSELING LICENSED CLINICAL SOCIAL WORKER INC
Entity type:Organization
Organization Name:PAS COUNSELING LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-224-9466
Mailing Address - Street 1:234 N EL MOLINO AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4404
Mailing Address - Country:US
Mailing Address - Phone:213-224-9466
Mailing Address - Fax:
Practice Address - Street 1:234 N EL MOLINO AVE STE 202
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4404
Practice Address - Country:US
Practice Address - Phone:213-224-9466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health