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NPI Code Detail

MEDICARE: SCION COUNSELING LLC

MEDICARE: SCION COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyLPCC 25CA

General Provider Information

NPI Number : 1396990362
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCION COUNSELING LLC
Provider Business Mailing Address
First Line : PO BOX 6331
Second Line :
City : LA QUINTA
State : CA
Zip : 92248-6331
Country : US
Telephone Number : 760-609-0808
Fax Number : 760-609-0808
Provider Business Practice Location Address
First Line : 43585 MONTEREY AVE.
Second Line : SUITE 4
City : PALM DESERT
State : CA
Zip : 92260-9398
Country : US
Telephone Number : 760-609-0808
Fax Number : 760-609-0808
Authorized Official
Title or Position : THERAPIST
Name : MR. CLINTON NEWELL
Credential : MA, LPCC
Telephone Number : 760-609-0808
Provider Enumeration Date : 11/18/2008
Last Update Date : 06/16/2015

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