=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104633510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING LIGHT-COUNSELING & COACHING LICENSED CLINICAL SOCIAL WORKER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2024
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1626 PLAZA DEL AMO
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-5267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-270-6656
-----------------------------------------------------
Fax | 909-606-7944
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1626 PLAZA DEL AMO
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-5267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-270-6656
-----------------------------------------------------
Fax | 909-606-7944
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | DR. AMY LEE HUANG
-----------------------------------------------------
Credential | DSW, LCSW
-----------------------------------------------------
Telephone | 909-270-6656
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------