MEDICARE: CENTER OF MENTAL AND SPIRITUAL WELLNESS

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	:	1942132857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER OF MENTAL AND SPIRITUAL WELLNESS

Provider Business Mailing Address
First Line	:	1716 W POPLAR ST
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90220-1457
Country	:	US
Telephone Number	:	425-366-6753
Fax Number	:

Provider Business Practice Location Address
First Line	:	1716 W POPLAR ST
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90220-1457
Country	:	US
Telephone Number	:	425-366-6753
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LONDEN GATEWOOD
Credential	:	LMFT
Telephone Number	:	818-447-1451

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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