Healthcare Provider Details

I. General information

NPI: 1316623143
Provider Name (Legal Business Name): ROSANA CORIA, LICENSED CLINICAL SOCIAL WORKER, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E OLIVE AVE # 667
BURBANK CA
91502-1820
US

IV. Provider business mailing address

135 E OLIVE AVE # 667
BURBANK CA
91502-1820
US

V. Phone/Fax

Practice location:
  • Phone: 818-338-2707
  • Fax: 818-304-9051
Mailing address:
  • Phone: 818-338-2707
  • Fax: 818-304-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROSANA CORIA
Title or Position: OWNER / AUTHORIZED OFFICIAL
Credential: LCSW
Phone: 818-338-2702