Healthcare Provider Details

I. General information

NPI: 1780496042
Provider Name (Legal Business Name): BRILLA COUNSELING SERVICES CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 57TH ST
SACRAMENTO CA
95819-3328
US

IV. Provider business mailing address

924 57TH ST
SACRAMENTO CA
95819-3328
US

V. Phone/Fax

Practice location:
  • Phone: 415-322-0520
  • Fax:
Mailing address:
  • Phone: 916-287-8876
  • Fax: 916-287-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAUREN DIBBLE
Title or Position: OWNER AND CLINICAL DIRECTOR
Credential: MA, LMFT 123427
Phone: 916-287-8876