Provider Demographics
NPI:1861814394
Name:NAMASTE COUNSELING SERVICES
Entity type:Organization
Organization Name:NAMASTE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUMNER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:209-205-9084
Mailing Address - Street 1:4750 QUAIL LAKES DR
Mailing Address - Street 2:C-4
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5274
Mailing Address - Country:US
Mailing Address - Phone:209-205-9084
Mailing Address - Fax:
Practice Address - Street 1:4750 QUAIL LAKES DR
Practice Address - Street 2:C-4
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5274
Practice Address - Country:US
Practice Address - Phone:209-205-9084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1400115395251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health