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General NPI Number Information
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NPI Number | 1174661284
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Entity Type | Organization
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Legal Business Name | REDWOOD COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 99 S HUMBOLDT ST
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City | WILLITS
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State | CA
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Zip | 95490-3509
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Country | US
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Telephone | 707-459-9900
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Fax | 707-459-9904
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Provider Business Mailing Address
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Address Line | PO BOX 2462
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City | WILLITS
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State | CA
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Zip | 95490-2462
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Country | US
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Telephone | 707-459-9900
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Fax | 707-459-9904
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Authorized Official
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Title or Position | CHIEF EXECUTIVE DIRECTOR
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Name | MRS. VICTORIA JERUSHA KELLY
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Credential | LCSW
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Telephone | 707-467-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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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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