Provider Demographics
NPI:1881081362
Name:CUCAMONGA COUNSELING
Entity type:Organization
Organization Name:CUCAMONGA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARKADIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-962-7323
Mailing Address - Street 1:9565 BUSINESS CENTER DR STE C
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4560
Mailing Address - Country:US
Mailing Address - Phone:909-962-7323
Mailing Address - Fax:909-962-7323
Practice Address - Street 1:9565 BUSINESS CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4560
Practice Address - Country:US
Practice Address - Phone:909-962-7323
Practice Address - Fax:909-962-7323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health