| Clear Lake Counseling Center | |
|
149 N Main St Suite 210 Lakeport CA 95453-4832 | |
| (707) 262-0400 | |
| (707) 262-0340 |
| Full Name | Clear Lake Counseling Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 149 N Main St, Lakeport, California |
| Authorized Official Name and Position | Taira St. John (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7072620400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Counseling Center Po Box 716 Lakeport CA 95453-0716 Ph: (707) 262-0400 | Clear Lake Counseling Center 149 N Main St Suite 210 Lakeport CA 95453-4832 Ph: (707) 262-0400 |
| NPI Number | 1417272501 |
|---|---|
| Provider Enumeration Date | 03/31/2010 |
| Last Update Date | 03/31/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417272501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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