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NPI Code Detail

MEDICARE: GRIT MINDSET THERAPY A LICENSED CLINICAL SOCIAL WORKER CORPORATION

MEDICARE: GRIT MINDSET THERAPY A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11518117662OTHERCANPI

General Provider Information

NPI Number : 1124617162
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRIT MINDSET THERAPY A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Provider Business Mailing Address
First Line : 800 W EL CAMINO REAL STE 180
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-2586
Country : US
Telephone Number : 650-880-3132
Fax Number :
Provider Business Practice Location Address
First Line : 800 W EL CAMINO REAL STE 180
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-2586
Country : US
Telephone Number : 650-880-3132
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MUNNYUAN SAECHAO
Credential : PSYD, LCSW
Telephone Number : 650-880-3132
Provider Enumeration Date : 01/14/2021
Last Update Date : 11/11/2022

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Directions to “GRIT MINDSET THERAPY A LICENSED CLINICAL SOCIAL WORKER CORPORATION ” Practice Location

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