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General NPI Number Information
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NPI Number | 1033730072
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Entity Type | Organization
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Legal Business Name | WHOLENESS EMPOWERMENT GROUP LICENSED CLINICAL SOCIAL WORKER, INC
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 11/04/2023
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Provider Practice Location Address
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Address Line | 22365 BARTON RD STE 302
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5078
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Country | US
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Telephone | 909-649-6111
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Fax | 877-602-0232
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Provider Business Mailing Address
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Address Line | 2910 S ARCHIBALD AVE STE A
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City | ONTARIO
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State | CA
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Zip | 91761-7358
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Country | US
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Telephone | 909-572-3055
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Fax | 877-602-0232
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | FRANCES AHUNNA OHAERI
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Credential | LCSW
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Telephone | 909-572-3055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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