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General NPI Number Information
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NPI Number | 1952251225
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Entity Type | Organization
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Legal Business Name | AWAKEN INSIGHT COUNSELING LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 277 DOLPHIN WAY
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-1516
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Country | US
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Telephone | 805-208-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 668 N COAST HWY STE 135
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-1513
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Country | US
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Telephone | 805-208-7788
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | JESSE RYAN CARDIN
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Credential | LCSW
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Telephone | 805-208-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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