Provider Demographics
NPI:1861945537
Name:ACTION FAMILY COUNSELING
Entity type:Organization
Organization Name:ACTION FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:CORRELL
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:805-660-8719
Mailing Address - Street 1:4380 APRICOT RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2317
Mailing Address - Country:US
Mailing Address - Phone:805-584-3258
Mailing Address - Fax:805-584-3765
Practice Address - Street 1:4380 APRICOT RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2317
Practice Address - Country:US
Practice Address - Phone:805-584-3258
Practice Address - Fax:805-584-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560026AP261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder