Healthcare Provider Details
I. General information
NPI: 1902515463
Provider Name (Legal Business Name): SOCIAL CONNECTIONS COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/23/2022
Last Update Date: 11/23/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27201 TOURNEY RD STE 200G
VALENCIA CA
91355-5900
US
IV. Provider business mailing address
27201 TOURNEY RD STE 200G
VALENCIA CA
91355-5900
US
V. Phone/Fax
- Phone: 818-439-7730
- Fax:
- Phone: 818-439-7730
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIKA
C
PERRY-DUTTON
Title or Position: OWNER/ CLINICAL DIRECTOR
Credential: MFT
Phone: 818-439-7730