Provider Demographics
NPI:1386102184
Name:PLACE, ARIEL (PSYD, LPCC)
Entity type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:
Last Name:PLACE
Suffix:
Gender:F
Credentials:PSYD, LPCC
Other - Prefix:DR
Other - First Name:ARIEL
Other - Middle Name:
Other - Last Name:PLACE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LPCC
Mailing Address - Street 1:6441 REXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6319
Mailing Address - Country:US
Mailing Address - Phone:540-664-7804
Mailing Address - Fax:
Practice Address - Street 1:6441 REXFORD WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6319
Practice Address - Country:US
Practice Address - Phone:540-664-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8827101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health