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General NPI Number Information
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NPI Number | 1699635029
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Entity Type | Organization
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Legal Business Name | GOLDEN THREAD THERAPY & COUNSELING, LICENSED CLINICAL SOCIAL WORKER, PC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 3101 OCEAN PARK BLVD STE 100
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City | SANTA MONICA
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State | CA
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Zip | 90405-3029
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Country | US
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Telephone | 323-918-5410
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 OCEAN PARK BLVD STE 100
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City | SANTA MONICA
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State | CA
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Zip | 90405-3029
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Country | US
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Telephone | 323-918-5410
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MAYA SUTTA-GOMEZ
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Credential |
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Telephone | 323-918-5410
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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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