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General NPI Number Information
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NPI Number | 1528937166
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Entity Type | Organization
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Legal Business Name | DEVELOP - ACHIEVE - SUCCEED
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1225 W 190TH ST
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City | GARDENA
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State | CA
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Zip | 90248-4320
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Country | US
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Telephone | 323-443-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 8517 ELBURG ST UNIT D
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City | PARAMOUNT
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State | CA
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Zip | 90723-2884
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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 | OWNER/MANAGER
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Name | DIVINITY SARDIN
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Credential | LCSW
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Telephone | 323-252-1859
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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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Taxonomy #2
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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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