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General NPI Number Information
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NPI Number | 1508402363
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Entity Type | Organization
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Legal Business Name | COLDWATER COUNSELING CENTER, INC
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 4419 COLDWATER CANYON AVE STE E
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City | STUDIO CITY
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State | CA
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Zip | 91604-1478
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Country | US
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Telephone | 818-508-0703
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Fax | 818-508-0703
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Provider Business Mailing Address
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Address Line | 20301 VENTURA BLVD STE 214
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-0932
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Country | US
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Telephone | 818-508-0703
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN GALIPEAU
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Credential | LMFT
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Telephone | 818-508-0703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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