MEDICARE: HONEY TREE LICENSED CLINICAL SOCIAL WORKER THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1053206250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONEY TREE LICENSED CLINICAL SOCIAL WORKER THERAPY INC

Provider Business Mailing Address
First Line	:	2050 N TUSTIN ST # 1016
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-3902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 E WHITECAP AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1831
Country	:	US
Telephone Number	:	775-800-6484
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JASMYNNE SPENCE
Credential	:	LCSW
Telephone Number	:	714-277-8981

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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