Healthcare Provider Details
I. General information
NPI: 1619824687
Provider Name (Legal Business Name): LOOKING GLASS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
731 SANTA YSABEL AVE
LOS OSOS CA
93402-1137
US
IV. Provider business mailing address
731 SANTA YSABEL AVE
LOS OSOS CA
93402-1137
US
V. Phone/Fax
- Phone: 406-219-1525
- Fax:
- Phone: 406-219-1525
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELA
KNUCKLES
Title or Position: OWNER
Credential: MA, LPCC
Phone: 406-314-5959