Individual provider · Type 1 NPI

Justin Surachai Tanyavutti, LPCC

Professional Counselor · Berkeley, CA

NPI number 1538559166 Active

Practice location

1918 Bonita Ave
Berkeley, CA 94704

Call (703) 261-9973 Map

Mailing address

PO Box 2543
Berkeley, CA 94702-0543

Other practice locations

  • 5225 Old Orchard Rd, Suite 37, Skokie, IL 60077-4405 · (847) 529-8300

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500X178.010560 (IL)
Professional Counselor Primary 101YP2500XLPCC6651 (CA)

Professional Counselor: Definition to come...

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About NPI 1538559166

Justin Surachai Tanyavutti, LPCC's National Provider Identifier is 1538559166, issued on Feb 3, 2015. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Berkeley, CA. The record was last updated on Sep 16, 2019.