Healthcare Provider Details

I. General information

NPI: 1740051713
Provider Name (Legal Business Name): CARING CONVERSATIONS MARRIAGE AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11896 WELBY PL
MORENO VALLEY CA
92557-6444
US

IV. Provider business mailing address

11896 WELBY PL
MORENO VALLEY CA
92557-6444
US

V. Phone/Fax

Practice location:
  • Phone: 562-225-4150
  • Fax:
Mailing address:
  • Phone: 562-225-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAREN LYNNETTE SADEWATER
Title or Position: CEO
Credential:
Phone: 562-225-4150