Healthcare Provider Details

I. General information

NPI: 1679411052
Provider Name (Legal Business Name): CALLIOPE COAST THERAPY GROUP, A LICENSED PROFESSIONAL CLINICAL COUNSELOR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 WATT AVE STE 165
SACRAMENTO CA
95821-2676
US

IV. Provider business mailing address

1537 35TH ST
SACRAMENTO CA
95816-6601
US

V. Phone/Fax

Practice location:
  • Phone: 805-947-0785
  • Fax:
Mailing address:
  • Phone: 916-837-8749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KARYN NOEL
Title or Position: CEO
Credential: LMFT, LPCC, LPC
Phone: 805-947-0785