Provider Demographics
NPI:1831214410
Name:THE CENTER FOR INDIVIDUAL & FAMILY COUNSELING
Entity type:Organization
Organization Name:THE CENTER FOR INDIVIDUAL & FAMILY COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:WINSTON
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-761-2227
Mailing Address - Street 1:5445 LAUREL CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4661
Mailing Address - Country:US
Mailing Address - Phone:818-761-2227
Mailing Address - Fax:818-759-2959
Practice Address - Street 1:5445 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-4661
Practice Address - Country:US
Practice Address - Phone:818-761-2227
Practice Address - Fax:818-759-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38804251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherPRIVATE NON-PROFIT AGENCY