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General NPI Number Information
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NPI Number | 1245874163
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Entity Type | Organization
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Legal Business Name | MYNDHEAL, CORP
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 20721 LEMARSH ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-3266
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Country | US
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Telephone | 916-400-0633
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3663
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City | CHATSWORTH
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State | CA
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Zip | 91313-3663
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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 | AJITA GUPTA
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Credential | LCSW
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Telephone | 916-400-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 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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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #10
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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 #11
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #12
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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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