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General NPI Number Information
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NPI Number | 1225060874
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Entity Type | Organization
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Legal Business Name | THE SUPPORT PROJECT, INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3527 SACRAMENTO ST STE 102
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1884
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Country | US
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Telephone | 415-563-3294
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Fax | 510-531-4764
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Provider Business Mailing Address
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Address Line | 3527 SACRAMENTO ST STE 102
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1884
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Country | US
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Telephone | 415-563-3294
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Fax | 510-531-4764
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT COE
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Credential | LCSW
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Telephone | 415-563-3294
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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 | LCS 15838
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License Number State | CA
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