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General NPI Number Information
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NPI Number | 1861026080
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Entity Type | Organization
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Legal Business Name | URBAN CATALYST PSYCHOTHERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPOR
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 400 29TH ST STE 308
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City | OAKLAND
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State | CA
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Zip | 94609-3548
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Country | US
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Telephone | 510-698-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 NORBRIDGE AVE # G
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5700
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Country | US
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Telephone | 510-698-1100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BRANDY GADSON
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Credential | LCSW
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Telephone | 510-909-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 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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