Healthcare Provider Details

I. General information

NPI: 1538757919
Provider Name (Legal Business Name): WHOLE PERSON THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2021
Last Update Date: 01/01/2021
Certification Date: 01/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E BROADWAY STE 254
LONG BEACH CA
90802-3162
US

IV. Provider business mailing address

5942 EDINGER AVE STE 113254
HUNTINGTON BEACH CA
92649-1763
US

V. Phone/Fax

Practice location:
  • Phone: 562-888-1856
  • Fax:
Mailing address:
  • Phone: 562-888-1856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: HELEN CALDWELL
Title or Position: PRESIDENT
Credential:
Phone: 562-888-1856