Healthcare Provider Details

I. General information

NPI: 1487508537
Provider Name (Legal Business Name): INLY THERAPY, LICENSED CLINICAL SOCIAL WORKER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 EAST COLORADO BLVD 5TH FLOOR PMB COL-5247
PASADENA CA
91106
US

IV. Provider business mailing address

1055 EAST COLORADO BLVD 5TH FLOOR PMB COL-5247
PASADENA CA
91106
US

V. Phone/Fax

Practice location:
  • Phone: 424-410-3744
  • Fax:
Mailing address:
  • Phone: 424-410-3744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RUIQI HE
Title or Position: FOUNDER/OWNER
Credential: LCSW
Phone: 424-410-3744