| Counseling Associates Of The Southland, Incorporated | |
|
680 Langsdorf Dr Ste 219 Fullerton CA 92831-3702 | |
| (714) 578-0990 | |
| (714) 449-9252 |
| Full Name | Counseling Associates Of The Southland, Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 680 Langsdorf Dr Ste 219, Fullerton, California |
| Authorized Official Name and Position | Regina Catherine Peck-sobolewski (OWNER) |
| Authorized Official Contact | 6263676269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Associates Of The Southland, Incorporated 680 Langsdorf Dr Ste 219 Fullerton CA 92831-3702 Ph: (714) 578-0990 | Counseling Associates Of The Southland, Incorporated 680 Langsdorf Dr Ste 219 Fullerton CA 92831-3702 Ph: (714) 578-0990 |
| NPI Number | 1255816898 |
|---|---|
| Provider Enumeration Date | 09/29/2018 |
| Last Update Date | 09/03/2019 |
| Medicare PECOS PAC ID | 8022447218 |
|---|---|
| Medicare Enrollment ID | O20200409002305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255816898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Andrea Hennum Fell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083848519 PECOS PAC ID: 5395174585 Enrollment ID: I20200416002186 |
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