Provider Demographics
NPI:1962092445
Name:OAK CREEK RELATIONAL COUNSELING CENTER
Entity type:Organization
Organization Name:OAK CREEK RELATIONAL COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-822-5937
Mailing Address - Street 1:2100 MONUMENT BLVD STE 17
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3400
Mailing Address - Country:US
Mailing Address - Phone:925-822-5937
Mailing Address - Fax:925-822-5937
Practice Address - Street 1:2100 MONUMENT BLVD STE 17
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3400
Practice Address - Country:US
Practice Address - Phone:925-822-5937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty