# INNOVATIONS COUNSELING SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043539026
- **Authorized official:** MRS. DIANE C. MCNEAL (CEO)
- **Authorized official phone:** (323) 326-0860

## Contact information

- **Practice address:** 3756 SANTA ROSALIA DR., SUITE \# 617, LOS ANGELES, CA 90008
- **Practice address phone:** (323) 326-0860
- **Practice address fax:** (323) 296-3332
- **Mailing address:** 37744 VINTAGE DR, PALMDALE, CA 93550-7021
- **Mailing address phone:** (323) 326-0860
- **Mailing address fax:** (323) 296-3332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XM0800X | Mental Health Occupational Therapist | — | NULL | — |
| 225XM0800X | Mental Health Occupational Therapist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 302R00000X | Health Maintenance Organization | 104360CCBCDC | CA | Yes |

## Other

- **Enumeration date:** 05/29/2010
- **Last updated:** 06/25/2019