Healthcare Provider Details

I. General information

NPI: 1255909099
Provider Name (Legal Business Name): COUNSELING FOR THE BODY MIND AND SPIRIT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N KENOSHA DR
MADISON WI
53705
US

IV. Provider business mailing address

892 20TH ST
OAKLAND CA
94607-3351
US

V. Phone/Fax

Practice location:
  • Phone: 415-971-6438
  • Fax:
Mailing address:
  • Phone: 415-971-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ALLISON NANCY ZAMANI
Title or Position: PRESIDENT
Credential: LPCC
Phone: 415-971-6438