Healthcare Provider Details

I. General information

NPI: 1023865888
Provider Name (Legal Business Name): GENTLE GUIDANCE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43751 BEECH AVE
LANCASTER CA
93534-5004
US

IV. Provider business mailing address

43751 BEECH AVE
LANCASTER CA
93534-5004
US

V. Phone/Fax

Practice location:
  • Phone: 323-313-5747
  • Fax:
Mailing address:
  • Phone: 323-313-5747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUDITH SORTO
Title or Position: CEO
Credential: LCSW
Phone: 323-313-5747