Provider Demographics
NPI:1124237748
Name:PRUITT, GEONE (COUNSELOR)
Entity type:Individual
Prefix:MS
First Name:GEONE
Middle Name:
Last Name:PRUITT
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 S SEPULVEDA BLVD
Mailing Address - Street 2:# F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3477
Mailing Address - Country:US
Mailing Address - Phone:213-804-9222
Mailing Address - Fax:
Practice Address - Street 1:2500 WILSHIRE BLVD
Practice Address - Street 2:SUITE 922
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4303
Practice Address - Country:US
Practice Address - Phone:213-487-9800
Practice Address - Fax:213-487-9800
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool