| Counseling And Neuro Dynamics, Inc. | |
|
4101 Mcgowen St Ste 233 Long Beach CA 90808-1898 | |
| (562) 714-2146 | |
| (708) 824-0555 |
| Full Name | Counseling And Neuro Dynamics, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4101 Mcgowen St Ste 233, Long Beach, California |
| Authorized Official Name and Position | Devone Verse (DIRECTOR) |
| Authorized Official Contact | 7736192001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling And Neuro Dynamics, Inc. 7725 Dean Martin Dr Las Vegas NV 89139-6612 Ph: (773) 619-2001 | Counseling And Neuro Dynamics, Inc. 4101 Mcgowen St Ste 233 Long Beach CA 90808-1898 Ph: (562) 714-2146 |
| NPI Number | 1619686557 |
|---|---|
| Provider Enumeration Date | 11/18/2022 |
| Last Update Date | 11/18/2022 |
| Certification Date | 11/18/2022 |
| Medicare PECOS PAC ID | 8527412089 |
|---|---|
| Medicare Enrollment ID | O20231002003548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619686557 | NPI | - | NPPES |
| Provider Name | Dominique Roumain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144570078 PECOS PAC ID: 6103064407 Enrollment ID: I20130528000511 |
| Provider Name | Keshaun Necole Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376164608 PECOS PAC ID: 5890142442 Enrollment ID: I20231103002272 |
| Provider Name | Mikkal Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942537477 PECOS PAC ID: 6800233321 Enrollment ID: I20240320001053 |
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