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General NPI Number Information
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NPI Number | 1982410908
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Entity Type | Organization
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Legal Business Name | COURAGEOUS HEARTS COUNSELING CENTER LLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2547 W SHAW AVE STE 114
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City | FRESNO
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State | CA
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Zip | 93711-3321
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Country | US
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Telephone | 559-422-0394
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Fax | 844-449-0753
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Provider Business Mailing Address
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Address Line | 2718 W NEBRASKA AVE
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City | CARUTHERS
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State | CA
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Zip | 93609-9505
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Country | US
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Telephone | 559-960-6994
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Fax | 844-449-0753
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLY M JONES
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Credential | EDD, LMFT
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Telephone | 559-422-0394
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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 | 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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