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General NPI Number Information
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NPI Number | 1861290264
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Entity Type | Organization
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Legal Business Name | TYS PROFESSIONAL CLINICAL COUNSELING & THERAPY, PC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 2211 POST ST STE 300
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3442
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Country | US
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Telephone | 669-288-1417
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Fax | 669-209-4714
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Provider Business Mailing Address
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Address Line | 2211 POST ST STE 300
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3442
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Country | US
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Telephone | 669-288-1417
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Fax | 669-209-4714
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Authorized Official
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Title or Position | CEO/CFO
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Name | JENNIFER TORRES DURAN
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Credential | LPCC
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Telephone | 669-288-1417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 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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