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Organization

NORTHSTAR LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES UKAOMA DOCTOR OF PSYCHOLOGY (PRESIDENT/ADMINISTRATOR)
(760) 270-9200
Entity
Organization

Contact information

Practice address
74710 HIGHWAY 111 STE 102, PALM DESERT, CA 92260-3820
(760) 270-9200
(888) 270-0801
Mailing address
1642 LAS CASITAS DR. 2503, BORREGO SPRINGS, CA 92004
(704) 668-6401
(888) 270-0801

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
08/26/2021
Last updated
08/26/2021
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