Provider Demographics
NPI:1316672355
Name:DRISHTI COUNSELING SERVICES CORP
Entity type:Organization
Organization Name:DRISHTI COUNSELING SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:LONITA
Authorized Official - Middle Name:DARRASIE
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC#1219
Authorized Official - Phone:209-986-7752
Mailing Address - Street 1:1869 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95203-1417
Mailing Address - Country:US
Mailing Address - Phone:209-986-7752
Mailing Address - Fax:
Practice Address - Street 1:1869 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-1417
Practice Address - Country:US
Practice Address - Phone:209-986-7752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty