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General NPI Number Information
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NPI Number | 1831900315
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Entity Type | Organization
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Legal Business Name | LAURA LIM LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 5053 LA MART DR STE 105
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City | RIVERSIDE
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State | CA
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Zip | 92507-5993
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Country | US
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Telephone | 626-322-8729
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Fax |
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Provider Business Mailing Address
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Address Line | 13353 LILYROSE ST
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City | CORONA
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State | CA
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Zip | 92880-0755
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Country | US
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Telephone | 626-322-8729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA LIM
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Credential | LCSW
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Telephone | 626-322-8729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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