Healthcare Provider Details
I. General information
NPI: 1518514215
Provider Name (Legal Business Name): COUNSELING4KIDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9377 VENA AVE
ARLETA CA
91331-4733
US
IV. Provider business mailing address
9377 VENA AVE
ARLETA CA
91331-4733
US
V. Phone/Fax
- Phone: 818-441-7800
- Fax:
- Phone: 818-441-7800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KYUNG-HWA KATHLEEN
KIM
Title or Position: CHIEF COMPLIANCE & QUALITY OFFICER
Credential: LMFT
Phone: 818-723-8286