Organization
PROVIDENCE BEHAVIORAL COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GODFREY NWOGENE (DIRECTOR)
(951) 625-8800
Entity
Organization
Contact information
Practice address
414 WEST GRAND STREET SUIT 372, CORONA, CA 92878
(951) 625-8800
Mailing address
414 WEST GRAND STREET SUIT 372, CORONA, CA 92878
(951) 625-8800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/20/2025
Last updated
08/29/2025
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