Healthcare Provider Details

I. General information

NPI: 1255299228
Provider Name (Legal Business Name): CLINICAL INTUITIONS COMMUNITY WELLNESS CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 W SCHOOL ST
COMPTON CA
90220-1844
US

IV. Provider business mailing address

1935 VIRGINIA ST NE
SALEM OR
97301-2269
US

V. Phone/Fax

Practice location:
  • Phone: 747-249-4383
  • Fax:
Mailing address:
  • Phone: 747-249-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: LEA HUMMEL
Title or Position: COO
Credential: QMHA
Phone: 747-249-4383