Provider Demographics
NPI:1134937709
Name:PSYCHOTHERAPY COUNSELING
Entity type:Organization
Organization Name:PSYCHOTHERAPY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JERI
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-888-0616
Mailing Address - Street 1:9640 MISSION GORGE RD # B147
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3854
Mailing Address - Country:US
Mailing Address - Phone:619-436-1343
Mailing Address - Fax:619-599-8543
Practice Address - Street 1:6776 CAMINITO DEL GRECO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2219
Practice Address - Country:US
Practice Address - Phone:619-888-0616
Practice Address - Fax:619-599-8543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty