Provider Demographics
NPI:1073383220
Name:BLACK GIRLS MENTAL HEALTH COLLECTIVE INC.
Entity Type:Organization
Organization Name:BLACK GIRLS MENTAL HEALTH COLLECTIVE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-377-9756
Mailing Address - Street 1:9307 ASTOR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1471
Mailing Address - Country:US
Mailing Address - Phone:904-377-9756
Mailing Address - Fax:
Practice Address - Street 1:9307 ASTOR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1471
Practice Address - Country:US
Practice Address - Phone:904-377-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty