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General NPI Number Information
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NPI Number | 1982312864
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Entity Type | Organization
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Legal Business Name | INCLUSIVE REPRODUCTIVE HEALING A LICENSED CLINICAL SOCIAL WORKER CO
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 3003 HEALTH CENTER DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-2700
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Country | US
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Telephone | 619-568-2608
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Fax | 619-415-8405
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Provider Business Mailing Address
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Address Line | 9921 CARMEL MOUNTAIN RD # 332
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City | SAN DIEGO
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State | CA
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Zip | 92129-2813
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Country | US
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Telephone | 619-568-2608
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Fax | 619-415-8405
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY HALVERSON
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Credential | LCSW
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Telephone | 619-568-2608
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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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