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General NPI Number Information
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NPI Number | 1730960253
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Entity Type | Organization
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Legal Business Name | KOKORO COUNSELING CENTER, INC., A LICENSED CLINICAL SOCIAL WORKER
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 341 BROADWAY ST STE 223
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City | CHICO
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State | CA
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Zip | 95928-5355
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Country | US
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Telephone | 530-433-9745
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Fax | 530-231-6380
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Provider Business Mailing Address
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Address Line | 1692 MANGROVE AVE PMB 136
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City | CHICO
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State | CA
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Zip | 95926-2648
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Country | US
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Telephone | 530-592-6939
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Fax | 530-231-6380
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | TERESA DIANE RICHMAN
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Credential | LCSW
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Telephone | 530-592-6939
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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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