Healthcare Provider Details

I. General information

NPI: 1497432439
Provider Name (Legal Business Name): MONICA E WILLIAMS, PROFESSIONAL CLINICAL COUNSELOR CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6621 E PACIFIC COAST HWY STE 220
LONG BEACH CA
90803-4239
US

IV. Provider business mailing address

28154 BOBWHITE CIR UNIT 72
SANTA CLARITA CA
91350-4416
US

V. Phone/Fax

Practice location:
  • Phone: 925-408-4663
  • Fax:
Mailing address:
  • Phone: 925-408-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MISS MONICA ELIZABETH WILLIAMS
Title or Position: CEO
Credential: LEP, LPCC
Phone: 925-408-4663