San Diego Divorce Counseling Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SAN DIEGO DIVORCE COUNSELING CENTER

Practice address

11622 El Camino Real Ste 100
San Diego, CA 92130-2051

Phone

(619) 865-3203

NPI assigned

Aug 12, 2019

Last updated

Aug 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lynn Waldman Flax, LCSW

Title

Owner/ Clinical Director

Phone

(619) 865-3203

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1356997761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 4TH AVE STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035716",
            "telephone_number": "619-865-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11622 EL CAMINO REAL STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302051",
            "telephone_number": "619-865-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO DIVORCE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "FLAX",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "WALDMAN",
        "authorized_official_title_or_position": "OWNER/ CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "619-865-3203",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lynn@divorcecounselingcenter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "San Diego",
            "address_1": "11622 El Camino Real Ste 100",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921302051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.