| The Counseling Place | |
|
12881 Knott St Ste 106 Garden Grove CA 92841-3939 | |
| (562) 716-3461 | |
| Not Available |
| Full Name | The Counseling Place |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 12881 Knott St Ste 106, Garden Grove, California |
| Authorized Official Name and Position | Laura Bosworth (THERAPIST) |
| Authorized Official Contact | 5627163461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Counseling Place 12881 Knott St Ste 106 Garden Grove CA 92841-3939 Ph: (562) 716-3461 | The Counseling Place 12881 Knott St Ste 106 Garden Grove CA 92841-3939 Ph: (562) 716-3461 |
| NPI Number | 1487022539 |
|---|---|
| Provider Enumeration Date | 09/07/2015 |
| Last Update Date | 09/07/2015 |
| Medicare PECOS PAC ID | 5799137543 |
|---|---|
| Medicare Enrollment ID | O20240117004277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487022539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LMFT53156 (California) | Secondary |
| 106H00000X | Marriage & Family Therapist | LMFT53156 (California) | Primary |
| Provider Name | Laura Diane Bosworth |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386965432 PECOS PAC ID: 7416309265 Enrollment ID: I20240117004313 |
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