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General NPI Number Information
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NPI Number | 1134937709
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY COUNSELING
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 6776 CAMINITO DEL GRECO
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City | SAN DIEGO
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State | CA
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Zip | 92120-2219
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Country | US
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Telephone | 619-888-0616
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Fax | 619-599-8543
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Provider Business Mailing Address
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Address Line | 9640 MISSION GORGE RD # B147
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City | SANTEE
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State | CA
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Zip | 92071-3854
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Country | US
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Telephone | 619-436-1343
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Fax | 619-599-8543
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Authorized Official
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Title or Position | CEO
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Name | MS. JERI E WILSON
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Credential | LCSW
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Telephone | 619-888-0616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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