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General NPI Number Information
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NPI Number | 1003367350
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Entity Type | Organization
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Legal Business Name | LIONS HEART COUNSELING LICENSED CLINICAL SOCIAL WORKER, INC
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 25 CADILLAC DR #132
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City | SACRAMENTO
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State | CA
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Zip | 95825
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Country | US
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Telephone | 916-494-9218
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Fax | 916-282-1698
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Provider Business Mailing Address
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Address Line | 25 CADILLAC DR #132
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City | SACRAMENTO
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State | CA
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Zip | 95825
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Country | US
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Telephone | 916-494-9218
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Fax | 916-282-1698
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES MEYER
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Credential | LCSW
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Telephone | 916-494-9218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 62672
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 62672
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License Number State | CA
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