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General NPI Number Information
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NPI Number | 1881589513
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Entity Type | Organization
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Legal Business Name | HEAD TO HEALTH LCSW INTEGRATIVE PSYCHOTHERAPY SERVICES
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 21 MIRA MAR AVE
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City | LONG BEACH
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State | CA
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Zip | 90803-2879
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Country | US
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Telephone | 510-415-1480
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Fax |
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Provider Business Mailing Address
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Address Line | 375 REDONDO AVE # 1135
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City | LONG BEACH
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State | CA
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Zip | 90814-2656
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Country | US
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Telephone | 510-415-1480
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | TACORA CAMILLE THOMAS
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Credential | LCSW
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Telephone | 510-415-1480
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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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