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Organization

IDENTICORP

Active
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Organization

IDENTICORP

Active
Other names
Molter Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES ROBERT MOLTER M.F.T. (EXECUTIVE VICE PRESIDENT)
(949) 742-0669
Entity
Organization

Contact information

Practice address
27001 LA PAZ RD STE 401, MISSION VIEJO, CA 92691-5502
(949) 742-0669
(949) 858-5431
Mailing address
19389 LIVE OAK CANYON RD, TRABUCO CANYON, CA 92679-3037
(949) 742-0669
(949) 858-5431

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MFC46277
CA
101YM0800X
Mental Health Counselor
Primary
MFC46701
CA

Other

Enumeration date
05/20/2013
Last updated
05/20/2013
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