Provider Demographics
NPI:1326858416
Name:PEOPLE'S HEALTH INITIATIVE COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:PEOPLE'S HEALTH INITIATIVE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MALIK-HAKIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KADIR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LPC, LMHC
Authorized Official - Phone:949-491-3795
Mailing Address - Street 1:29351 ST ANDREWS
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4374
Mailing Address - Country:US
Mailing Address - Phone:949-491-3795
Mailing Address - Fax:
Practice Address - Street 1:5441 S MACADAM AVE STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-6106
Practice Address - Country:US
Practice Address - Phone:949-491-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health