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General NPI Number Information
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NPI Number | 1932732997
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Entity Type | Organization
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Legal Business Name | EDISON COUNSELING CENTER
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 879 W 190TH ST STE 400
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City | GARDENA
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State | CA
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Zip | 90248-4223
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Country | US
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Telephone | 310-853-2758
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Fax | 909-456-8094
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Provider Business Mailing Address
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Address Line | 879 W 190TH ST STE 400
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City | GARDENA
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State | CA
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Zip | 90248-4223
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Country | US
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Telephone | 310-853-2758
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Fax | 310-953-8420
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Authorized Official
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Title or Position | OWNER
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Name | DR. AREASE N EDISON
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Credential | EDD, LMFT
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Telephone | 310-853-2758
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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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