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General NPI Number Information
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NPI Number | 1669851432
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Entity Type | Organization
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Legal Business Name | MY CHOICE COUNSELING SERVICES
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 4910 VAN NUYS BLVD SUITE 301
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1715
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Country | US
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Telephone | 818-671-4293
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Fax |
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Provider Business Mailing Address
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Address Line | 6520 PLATT AVE #416
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City | WEST HILLS
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State | CA
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Zip | 91307-3218
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Country | US
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Telephone | 818-671-4293
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. AMANDA G SOMDAL
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Credential | LCSW
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Telephone | 818-571-4293
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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 | LCS21161
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License Number State | CA
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