Provider Demographics
NPI:1447885272
Name:MODERN PARENTING SOLUTIONS PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:MODERN PARENTING SOLUTIONS PSYCHOLOGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:909-326-2562
Mailing Address - Street 1:1030 NEVADA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2957
Mailing Address - Country:US
Mailing Address - Phone:909-326-2562
Mailing Address - Fax:909-658-8734
Practice Address - Street 1:1030 NEVADA ST STE 103
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2957
Practice Address - Country:US
Practice Address - Phone:909-326-2562
Practice Address - Fax:909-658-8734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty