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General NPI Number Information
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NPI Number | 1508069881
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Entity Type | Organization
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Legal Business Name | THE MAPLE COUNSELING CENTER
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1945 S LA CIENEGA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-1601
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Country | US
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Telephone | 818-723-8286
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Fax | 310-247-4910
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Provider Business Mailing Address
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Address Line | 1945 S LA CIENEGA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-1601
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Country | US
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Telephone | 310-271-9999
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Fax | 310-247-4910
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | MARIANNE HUSBY CALLAHAN
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Credential | PH.D.
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Telephone | 310-271-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 960000209
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License Number State | CA
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