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General NPI Number Information
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NPI Number | 1558964791
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Entity Type | Organization
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Legal Business Name | RAINBOW CONNECTION PROFESSIONAL CLINICAL COUNSELOR SERVICE PC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1223 CLEVELAND AVE STE 200-245
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City | SAN DIEGO
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State | CA
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Zip | 92103-3301
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Country | US
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Telephone | 425-296-9793
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 CLEVELAND AVE # 200-245
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City | SAN DIEGO
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State | CA
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Zip | 92103-3301
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Country | US
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Telephone | 425-296-9793
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HARRY DIXON
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Credential | MA, LMHC, LPCC
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Telephone | 425-296-9793
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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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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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