Healthcare Provider Details

I. General information

NPI: 1184423386
Provider Name (Legal Business Name): HUMBOLDT COUNSELING CONNECTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 F ST
EUREKA CA
95501-1006
US

IV. Provider business mailing address

123 F ST STE F
EUREKA CA
95501-1048
US

V. Phone/Fax

Practice location:
  • Phone: 707-390-0393
  • Fax:
Mailing address:
  • Phone: 707-390-0393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAMELA CHRISTIANSEN
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 707-572-5767