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General NPI Number Information
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NPI Number | 1487222899
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Entity Type | Organization
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Legal Business Name | ENLIGHTENMENT FAMILY COUNSELING
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Dates
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Enumeration Date | 06/12/2021
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Last Update Date | 06/12/2021
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Provider Practice Location Address
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Address Line | 2333 W WHITENDALE AVE STE D
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City | VISALIA
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State | CA
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Zip | 93277-8701
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Country | US
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Telephone | 559-329-0778
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Fax |
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Provider Business Mailing Address
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Address Line | 2718 W PORTER AVE
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City | VISALIA
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State | CA
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Zip | 93291-8021
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Country | US
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Telephone | 559-308-6051
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERARDO CASTRO
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Credential | LCSW84947
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Telephone | 559-308-6051
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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 |
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License Number State |
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