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General NPI Number Information
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NPI Number | 1124157854
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION OF ORANGE COUNTY
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 2416 S MAIN ST SUITE A & B, WIT COURT & CHOICES FSP
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City | SANTA ANA
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State | CA
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Zip | 92707-3255
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Country | US
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Telephone | 714-668-8498
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Fax | 714-668-8499
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Provider Business Mailing Address
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Address Line | 822 W TOWN AND COUNTRY RD WIT COURT & CHOICES FSP
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City | ORANGE
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State | CA
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Zip | 92868-4712
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Country | US
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Telephone | 714-547-7559
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Fax | 714-543-4431
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JEFFREY A THRASH
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Credential | MFT
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Telephone | 714-547-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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