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General NPI Number Information
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NPI Number | 1831785260
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Entity Type | Organization
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Legal Business Name | AG COUNSELING SERVICES
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 12/20/2020
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Provider Practice Location Address
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Address Line | 333 E GLENOAKS BLVD STE 101
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City | GLENDALE
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State | CA
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Zip | 91207-2096
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Country | US
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Telephone | 818-355-2429
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Fax |
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Provider Business Mailing Address
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Address Line | 3727 W MAGNOLIA BLVD # 141
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City | BURBANK
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State | CA
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Zip | 91505-2818
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Country | US
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Telephone | 818-355-2429
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AZAD GALUSTIAN
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Credential | LCSW
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Telephone | 818-355-2429
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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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