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General NPI Number Information
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NPI Number | 1346462082
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Entity Type | Organization
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Legal Business Name | INTERCOMMUNITY COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7702 WASHINGTON AVE SUITE D
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City | WHITTIER
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State | CA
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Zip | 90602-2200
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Country | US
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Telephone | 562-698-1272
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Fax | 562-698-1274
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Provider Business Mailing Address
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Address Line | 7702 WASHINGTON AVE SUITE D
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City | WHITTIER
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State | CA
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Zip | 90602-2200
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Country | US
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Telephone | 562-698-1272
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Fax | 562-698-1274
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | REBECCA EBERLE-ROMBERGER
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Credential | PSY.D.
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Telephone | 562-698-1272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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