Healthcare Provider Details

I. General information

NPI: 1144004698
Provider Name (Legal Business Name): LITTLE DOVE COUNSELING, A LICENSED CLINICAL SOCIAL WORKER, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 PANORAMIC WAY STE 202
WALNUT CREEK CA
94595-1627
US

IV. Provider business mailing address

31 PANORAMIC WAY STE 202
WALNUT CREEK CA
94595-1627
US

V. Phone/Fax

Practice location:
  • Phone: 415-578-0203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANNA SASSER-CHRISTIAN
Title or Position: THERAPIST/CEO
Credential: LCSW
Phone: 925-303-8189