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General NPI Number Information
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NPI Number | 1245604909
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Entity Type | Organization
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Legal Business Name | SONOMA COUNTY COUNSELING
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 3434 MENDOCINO AVE BUILDING C
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City | SANTA ROSA
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State | CA
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Zip | 95403-2274
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Country | US
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Telephone | 707-322-1929
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Fax | 707-540-0484
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Provider Business Mailing Address
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Address Line | PO BOX 9591
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City | SANTA ROSA
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State | CA
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Zip | 95405-1591
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Country | US
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Telephone | 707-322-1929
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Fax | 707-540-0484
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MR. PAUL E MARGOLIS
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Credential | LMFT
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Telephone | 707-322-1929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | LMFT34259
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License Number State | CA
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