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General NPI Number Information
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NPI Number | 1063285278
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Entity Type | Organization
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Legal Business Name | BAYSIDE COUNSELING AND CONSULTING A LICENSED CLINICAL SOCIAL WORKER
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 501 KEARNEY ST STE 2
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City | EL CERRITO
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State | CA
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Zip | 94530-3520
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Country | US
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Telephone | 510-470-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 SYCAMORE AVE UNIT 5061
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City | HERCULES
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State | CA
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Zip | 94547-6002
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Country | US
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Telephone | 510-892-2892
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Fax | 510-892-2892
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOUSHUMI SEN
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Credential | LCSW
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Telephone | 510-892-2892
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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 |
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License Number State |
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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 |
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License Number State |
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