| Northstar Licensed Professional Clinical Counselor, Inc | |
|
74710 Highway 111 Ste 102 Palm Desert CA 92260-3820 | |
| (760) 270-9200 | |
| (888) 270-0801 |
| Full Name | Northstar Licensed Professional Clinical Counselor, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 74710 Highway 111 Ste 102, Palm Desert, California |
| Authorized Official Name and Position | Charles Ukaoma (PRESIDENT/ADMINISTRATOR) |
| Authorized Official Contact | 7602709200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Licensed Professional Clinical Counselor, Inc 1642 Las Casitas Dr. 2503 Borrego Springs CA 92004 Ph: (704) 668-6401 | Northstar Licensed Professional Clinical Counselor, Inc 74710 Highway 111 Ste 102 Palm Desert CA 92260-3820 Ph: (760) 270-9200 |
| NPI Number | 1548937535 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 08/26/2021 |
| Certification Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548937535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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