NPIMap

Organization Active NPI

Counseling Associates of the Southland Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fullerton, CA
National Provider Identifier
1255816898
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNSELING ASSOCIATES OF THE SOUTHLAND INC
Practice address
680 Langsdorf Dr Ste 219
Fullerton, CA 92831-3702
Phone
(714) 578-0990
Fax
(714) 449-9252
NPI assigned
Sep 29, 2018
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Regina Catherine Peck-Sobolewski, LMFTNPI 1336268796
Title
Owner
Phone
(626) 367-6269

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

680 Langsdorf Dr Ste 219
Fullerton, CA 92831-3702

Mailing address

680 Langsdorf Dr Ste 209
Fullerton, CA 92831-3702
Phone (714) 578-0990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200409002305 CA Part B Supplier - Clinic/Group Practice 8022447218 Receives reassigned benefits from 1 practitioner
Practice locations: Fullerton, CA

National Provider Directory

National Provider Directory

Locations

680 Langsdorf Dr
Ste 209
Fullerton, CA 92831
Phone (714) 299-7939

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1255816898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR STE 209",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "714-578-0990",
            "fax_number": "714-449-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR STE 219",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "714-578-0990",
            "fax_number": "714-449-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF THE SOUTHLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-29",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "PECK-SOBOLEWSKI",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-367-6269",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.