Organization
WELLSPRING OF LIFE COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNI FUNK (PRESIDENT)
(310) 853-8023
Entity
Organization
Contact information
Practice address
2008 WEST CARSON STREET, SUITE 105, TORRANCE, CA 90501
(310) 853-8023
(310) 853-8023
Mailing address
4107 MCLAUGHLIN AVENUE, UNIT 9, LOS ANGELES, CA 90066
(310) 853-8023
(310) 853-8023
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMHC10028
FL
101YP2500X
Professional Counselor
Primary
LPCC1742
CA
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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