Healthcare Provider Details

I. General information

NPI: 1689331027
Provider Name (Legal Business Name): B&R COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 09/02/2025
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 W PLAYA DEL CARMEN
IMPERIAL CA
92251-8858
US

IV. Provider business mailing address

266 W PLAYA DEL CARMEN
IMPERIAL CA
92251-8858
US

V. Phone/Fax

Practice location:
  • Phone: 760-960-5250
  • Fax:
Mailing address:
  • Phone: 760-960-5250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN REISIN
Title or Position: MARRIAGE & FAMILY THERAPIST
Credential: LMFT
Phone: 760-960-5205