MEDICARE: CLOVER HEALING COLLECTIVE, A MARRIAGE AND FAMILY THERAPY 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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1477358711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOVER HEALING COLLECTIVE, A MARRIAGE AND FAMILY THERAPY CORPORATION

Provider Business Mailing Address
First Line	:	6265 GREENWICH DR STE 230
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6265 GREENWICH DR STE 230
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5921
Country	:	US
Telephone Number	:	619-752-4801
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	DR. KORE BROWN
Credential	:	LMFT
Telephone Number	:	619-752-4801

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/18/2025

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