Healthcare Provider Details

I. General information

NPI: 1316679723
Provider Name (Legal Business Name): WISE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2022
Last Update Date: 06/26/2022
Certification Date: 06/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 STRAND WAY
PERRIS CA
92571-7327
US

IV. Provider business mailing address

3870 STRAND WAY
PERRIS CA
92571-7327
US

V. Phone/Fax

Practice location:
  • Phone: 909-225-6920
  • Fax:
Mailing address:
  • Phone: 909-225-6920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DEVI SOPHIA WISE
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 909-225-6920