person
Justin Surachai Tanyavutti, LPCC
Professional Counselor in Berkeley, California
NPI 1538559166

Justin Surachai Tanyavutti is a Professional Counselor based in Berkeley, CA and is specialized in Professional. Justin Surachai Tanyavutti practices in Berkeley, CA and has the professional credentials of LPCC. The NPI Number for Justin Surachai Tanyavutti is 1538559166 and holds a License No. 178.010560 (California).

The current practice location address for Justin Surachai Tanyavutti is 1918 Bonita Ave, Berkeley, CA and can be reached out via phone at 703-261-9973.

Location: 1918 Bonita Ave, Berkeley, CA, 94702-0543
person
Provider Profile Details
NPI Number
1538559166
Provider Name
Justin Surachai Tanyavutti
Credential
LPCC
Provider Entity Type
Individual
Gender
Male
Address
1918 Bonita Ave, Berkeley, CA, 94702-0543
Phone Number
703-261-9973
Fax Number
Provider Enumeration Date
02/03/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1918 Bonita Ave
City
State
Zip
94704
Phone Number
703-261-9973
Fax Number
person
Provider Business Mailing Address Details
Address
1918 Bonita Ave
City
State
Zip
94704
Phone Number
703-261-9973
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
178.010560 (Illinois)
Definition
Definition to come...
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