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General NPI Number Information
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NPI Number | 1659765477
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Entity Type | Organization
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Legal Business Name | CARING HEARTS PLAY THERAPY
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 3400 IRVINE AVE SUITE 217
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3116
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Country | US
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Telephone | 949-682-9275
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 IRVINE AVE SUITE 217
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3116
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Country | US
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Telephone | 949-682-9275
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Fax |
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Authorized Official
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Title or Position | OWNER AND PSYCHOTHERAPIST
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Name | KIMBERLY BARTLETT
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Credential | MSW, LCSW, RPT-S
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Telephone | 949-872-7454
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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 25025
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License Number State | CA
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