Organization
STAGE OF LIFE COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DAHLEN LPCC (PRESIDENT-LPCC)
(310) 502-0164
Entity
Organization
Contact information
Practice address
23133 HAWTHORNE BLVD STE 207, TORRANCE, CA 90505-3729
(310) 502-0164
Mailing address
2390 CRENSHAW BLVD # 460, TORRANCE, CA 90501-3300
(310) 847-9084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPCC4827
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
05/08/2018
Last updated
09/13/2018
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