Healthcare Provider Details

I. General information

NPI: 1407438161
Provider Name (Legal Business Name): STRENGTH BASED, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 RIVERTON AVE
SUN VALLEY CA
91352-4519
US

IV. Provider business mailing address

9230 LA TUNA CANYON RD
SUN VALLEY CA
91352-2224
US

V. Phone/Fax

Practice location:
  • Phone: 818-645-6356
  • Fax:
Mailing address:
  • Phone: 818-645-6356
  • 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: LISA PULSIFER
Title or Position: CEO
Credential: LCSW
Phone: 661-418-8514