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General NPI Number Information
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NPI Number | 1124617162
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Entity Type | Organization
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Legal Business Name | GRIT MINDSET THERAPY A LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 800 W EL CAMINO REAL STE 180
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2586
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Country | US
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Telephone | 650-880-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W EL CAMINO REAL STE 180
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2586
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Country | US
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Telephone | 650-880-3132
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUNNYUAN SAECHAO
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Credential | PSYD, LCSW
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Telephone | 650-880-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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