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General NPI Number Information
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NPI Number | 1922952464
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Entity Type | Organization
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Legal Business Name | HALLOWS END COLLECTIVE LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 3 LAUREL LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2941
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Country | US
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Telephone | 760-505-9084
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Fax |
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Provider Business Mailing Address
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Address Line | 3 LAUREL LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2941
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Country | US
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Telephone | 760-505-9084
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHANICE WILLIAMS
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Credential | LCSW
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Telephone | 760-505-9084
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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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