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General NPI Number Information
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NPI Number | 1295122414
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Entity Type | Organization
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Legal Business Name | MOSAIC COUNSELING CENTER
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Dates
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Enumeration Date | 04/26/2015
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Last Update Date | 04/26/2015
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Provider Practice Location Address
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Address Line | 1430 TRUXTUN AVE 5TH FLOOR
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City | BAKERSFIELD
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State | CA
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Zip | 93301-5246
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Country | US
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Telephone | 661-665-6077
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Fax | 661-665-6077
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Provider Business Mailing Address
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Address Line | 1430 TRUXTUN AVE 5TH FLOOR
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City | BAKERSFIELD
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State | CA
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Zip | 93301-5246
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Country | US
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Telephone | 661-665-6077
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Fax | 661-665-6077
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | CHERILYN RENEE HAWORTH
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Credential | L.C.S.W.
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Telephone | 661-665-6077
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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 25929
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License Number State | CA
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