Triple Moon Psychotherapy Collective A Licensed Social Worker Corp
LBN: Triple Moon Psychotherapy Collective A Licensed Clinical Social Worker
Triple Moon Psychotherapy Collective A Licensed Social Worker Corp is an health care organization with primary practice located at 12371 Lewis St Ste 103 , Garden Grove CA 92840-4687. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty.
Triple Moon Psychotherapy Collective A Licensed Clinical Social Worker can be contacted via phone (949) 868-8255, or through Le Reve Renderos, Amy via phone (951) 870-1528.
Contact Information
Primary practice address
12371 Lewis St Ste 103
Garden Grove CA 92840-4687
Phone: (949) 868-8255
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1306587837 |
|---|---|
| LBN Legal business name | Triple Moon Psychotherapy Collective A Licensed Clinical Social Worker |
| DBA Doing business as | Triple Moon Psychotherapy Collective A Licensed Social Worker Corp |
| Authorized official | Le Reve Renderos, Amy LMFT LPCC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 6th, 2022 |
| Last updated | Oct 4th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306587837 | NPPES |
| California | MEDICAID | 100215178 |
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