Healthcare Provider Details

I. General information

NPI: 1801330212
Provider Name (Legal Business Name): STRENGTH TO GROW A LICENSED CLINICAL SOCIAL WORKER CORPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 SACRAMENTO ST SUITE A
BERKELEY CA
94702-2533
US

IV. Provider business mailing address

2880 SACRAMENTO ST SUITE A
BERKELEY CA
94702-2533
US

V. Phone/Fax

Practice location:
  • Phone: 510-585-3709
  • Fax: 510-298-5599
Mailing address:
  • Phone: 510-585-3709
  • Fax: 510-298-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number69890
License Number StateCA

VIII. Authorized Official

Name: ERYN REEDER
Title or Position: CEO
Credential: LCSW
Phone: 510-435-0324