Provider Demographics
NPI:1962762807
Name:HUMANISTIC COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:HUMANISTIC COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-229-4312
Mailing Address - Street 1:1942 MOUNT VERDUGO LN
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-6507
Mailing Address - Country:US
Mailing Address - Phone:909-272-8547
Mailing Address - Fax:
Practice Address - Street 1:12981 PERRIS BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-4102
Practice Address - Country:US
Practice Address - Phone:951-243-3500
Practice Address - Fax:951-243-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty