| Theraville Counseling Services, A Lcsw Corporation | |
|
202 E Airport Dr Ste 265 San Bernardino CA 92408-3444 | |
| (909) 939-5007 | |
| Not Available |
| Full Name | Theraville Counseling Services, A Lcsw Corporation |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 202 E Airport Dr Ste 265, San Bernardino, California |
| Authorized Official Name and Position | Crystal Burns (OWNER/CLINICIAN) |
| Authorized Official Contact | 9097673450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theraville Counseling Services, A Lcsw Corporation Po Box 559 Beaumont CA 92223-0559 Ph: (951) 386-9709 | Theraville Counseling Services, A Lcsw Corporation 202 E Airport Dr Ste 265 San Bernardino CA 92408-3444 Ph: (909) 939-5007 |
| NPI Number | 1366084360 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 11/04/2021 |
| Certification Date | 11/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366084360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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