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General NPI Number Information
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NPI Number | 1134267701
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Entity Type | Organization
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Legal Business Name | SMOKE TREE COUNSELING SERVICES
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 777 E TAHQUITZ CANYON WAY STE 200
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6797
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Country | US
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Telephone | 760-320-0446
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Fax | 760-320-0446
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Provider Business Mailing Address
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Address Line | 777 E TAHQUITZ WAY STE 200172
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6784
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Country | US
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Telephone | 760-320-0446
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. VICKI SALVIN
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Credential | LCSW
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Telephone | 760-320-0446
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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 | LCS10873
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License Number State | CA
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