Provider Demographics
NPI:1992523690
Name:EXPANSION COUNSELING CENTER
Entity type:Organization
Organization Name:EXPANSION COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIADEH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-734-0593
Mailing Address - Street 1:1705 WASHINGTON ST STE F
Mailing Address - Street 2:
Mailing Address - City:CALISTOGA
Mailing Address - State:CA
Mailing Address - Zip Code:94515-1573
Mailing Address - Country:US
Mailing Address - Phone:310-734-0593
Mailing Address - Fax:707-341-3725
Practice Address - Street 1:1705 WASHINGTON ST STE F
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1573
Practice Address - Country:US
Practice Address - Phone:310-734-0593
Practice Address - Fax:707-341-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty