Provider Demographics
NPI:1447864228
Name:CONSUMERS SELF HELP
Entity type:Organization
Organization Name:CONSUMERS SELF HELP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB-MENTOR TEAM LEAD
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:AMFT
Authorized Official - Phone:916-394-9195
Mailing Address - Street 1:7171 BOWLING DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2043
Mailing Address - Country:US
Mailing Address - Phone:916-394-9195
Mailing Address - Fax:
Practice Address - Street 1:7171 BOWLING DR STE 300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2043
Practice Address - Country:US
Practice Address - Phone:916-394-9195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty