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General NPI Number Information
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NPI Number | 1285168138
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Entity Type | Organization
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Legal Business Name | YOUNG HEALING THERAPY LICENSED CLINICAL SOCIAL WORKER INC
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 5028 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2814
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Country | US
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Telephone | 877-905-5700
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Fax | 844-334-9735
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Provider Business Mailing Address
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Address Line | 5028 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2814
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Country | US
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Telephone | 877-905-5700
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Fax | 844-334-9735
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | SAMATRA MONIQUE DOWNING
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Credential | LCSW, PPSC
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Telephone | 877-905-5700
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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 | 26970
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License Number State | CA
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