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NPI Code Detail

MEDICARE: COMMUNAL HEALING LICENSED CLINICAL SOCIAL WORKER CORPORATION

MEDICARE: COMMUNAL HEALING 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

General Provider Information

NPI Number : 1437959608
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNAL HEALING LICENSED CLINICAL SOCIAL WORKER CORPORATION
Provider Business Mailing Address
First Line : 1525 N ALVARADO ST UNIT 26057
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-7404
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2150 HILLHURST AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-2012
Country : US
Telephone Number : 213-207-6206
Fax Number : 323-916-2634
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : TANYX JORDAN-MADRIGAL
Credential : LCSW
Telephone Number : 213-207-6206
Provider Enumeration Date : 03/17/2025
Last Update Date : 05/15/2025

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Directions to “COMMUNAL HEALING LICENSED CLINICAL SOCIAL WORKER CORPORATION ” Practice Location

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