Providence Behavioral Counseling

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Legal business name

PROVIDENCE BEHAVIORAL COUNSELING

Practice address

414 West Grand Street Suit 372
Corona, CA 92878

Phone

(951) 625-8800

NPI assigned

Aug 20, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Godfrey Nwogene

Title

Director

Phone

(951) 625-8800

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1275410128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 WEST GRAND STREET SUIT 372",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92878",
            "telephone_number": "951-625-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 WEST GRAND STREET SUIT 372",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92878",
            "telephone_number": "951-625-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE BEHAVIORAL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "NWOGENE",
        "authorized_official_first_name": "GODFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-625-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Madison Diane Puccetti, PA
• Puissance Int'L Corporation

• Developmental Therapist in Corona, CA
• Providers in Corona, CA by specialty
• Developmental Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.