Organization
COVENANT COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE CARL WILSON DBH (DIRECTOR)
(760) 241-6044
Entity
Organization
Contact information
Practice address
851 S MOUNT VERNON AVE STE 7A, COLTON, CA 92324-3926
(760) 241-6044
Mailing address
851 S MOUNT VERNON AVE STE 7A, COLTON, CA 92324-3926
(760) 241-6044
(760) 820-2704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
LPCC2784
CA
Other
Enumeration date
12/21/2016
Last updated
05/18/2021
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