| Good Shepherd Counseling Clinic | |
|
30713 Riverside Dr Suite 203 Lake Elsinore CA 92530-4714 | |
| (951) 678-1642 | |
| Not Available |
| Full Name | Good Shepherd Counseling Clinic |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 30713 Riverside Dr, Lake Elsinore, California |
| Authorized Official Name and Position | Susan Marie Kell (OWNER) |
| Authorized Official Contact | 9516781642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Counseling Clinic 30713 Riverside Dr Suite 203 Lake Elsinore CA 92530-4714 Ph: (951) 678-1642 | Good Shepherd Counseling Clinic 30713 Riverside Dr Suite 203 Lake Elsinore CA 92530-4714 Ph: (951) 678-1642 |
| NPI Number | 1649591520 |
|---|---|
| Provider Enumeration Date | 06/15/2010 |
| Last Update Date | 06/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649591520 | NPI | - | NPPES |
| ZZZ54304Y | Other | CA | BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MFC39965 (California) | Primary |
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