Healthcare Provider Details

I. General information

NPI: 1326972290
Provider Name (Legal Business Name): HEALING PHASES OF HER A LICENSED CLINICAL SOCIAL WORKER CORPORATION ALL MINDSETS MATTER THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9719 LINCOLN VILLAGE DR STE 506
SACRAMENTO CA
95827-3331
US

IV. Provider business mailing address

9719 LINCOLN VILLAGE DR STE 506
SACRAMENTO CA
95827-3331
US

V. Phone/Fax

Practice location:
  • Phone: 916-805-6105
  • Fax:
Mailing address:
  • Phone: 916-805-6105
  • 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: LAVONNE RICKS
Title or Position: CEO/FOUNDER
Credential: LCSW
Phone: 916-805-6105