Basic Information
| Provider Information | |||||||||
| NPI: | 1528478971 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NURITH COUNSELING CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14416 HAMLIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914011486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188226550 | ||||||||
| FaxNumber: | 3102731818 | ||||||||
| Practice Location | |||||||||
| Address1: | 14416 HAMLIN ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914011486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188226550 | ||||||||
| FaxNumber: | 3102731818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2014 | ||||||||
| LastUpdateDate: | 05/06/2014 | ||||||||
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| AuthorizedOfficialLastName: | CHOCRON | ||||||||
| AuthorizedOfficialFirstName: | LUCIEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8188226550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | LMFT, PSY. D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC50440 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 103T00000X | MFC50440 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.