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NPI Code Detail

MEDICARE: GRIEF SOLUTIONS COUNSELING CENTER

MEDICARE: GRIEF SOLUTIONS COUNSELING CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCW18421CA
2324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1013445147
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRIEF SOLUTIONS COUNSELING CENTER
Provider Business Mailing Address
First Line : 18381 GOLDENWEST ST
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92648-1107
Country : US
Telephone Number : 949-887-1612
Fax Number : 714-842-7774
Provider Business Practice Location Address
First Line : 1119 W 7TH ST
Second Line :
City : SAN JACINTO
State : CA
Zip : 92582-3856
Country : US
Telephone Number : 844-493-4325
Fax Number : 714-842-7774
Authorized Official
Title or Position : CFO
Name : DR. CAROLE ANNE HARRIS
Credential : LCSW, PSYD
Telephone Number : 949-887-1612
Provider Enumeration Date : 06/02/2017
Last Update Date : 06/02/2017

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Directions to “GRIEF SOLUTIONS COUNSELING CENTER ” Practice Location

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