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General NPI Number Information
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NPI Number | 1154135416
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Entity Type | Organization
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Legal Business Name | PERSPECTIVE COUNSELING GROUP LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 890 MORSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95864-4922
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Country | US
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Telephone | 916-873-3394
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Fax |
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Provider Business Mailing Address
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Address Line | 1271 LOS RIOS DR
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City | CARMICHAEL
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State | CA
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Zip | 95608-6159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KELVIN BAKER
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Credential | LCSW
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Telephone | 916-873-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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