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NPI Code Detail

MEDICARE: ASD CONSULTANCY

MEDICARE: ASD CONSULTANCY
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1750583480
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASD CONSULTANCY
Provider Business Mailing Address
First Line : 4137 E. 7TH ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-5311
Country : US
Telephone Number : 562-433-7562
Fax Number :
Provider Business Practice Location Address
First Line : 4137 E 7TH ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-5311
Country : US
Telephone Number : 562-433-7562
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : NICKY PALMER
Credential : M.S LMFT
Telephone Number : 562-298-0603
Provider Enumeration Date : 06/04/2007
Last Update Date : 08/22/2020

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Directions to “ASD CONSULTANCY ” Practice Location

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