Provider Demographics
NPI:1093453912
Name:HEALMATIC GROUP PRACTICE A LICENSED CLINICAL SOCIAL WORK CORPORATION
Entity Type:Organization
Organization Name:HEALMATIC GROUP PRACTICE A LICENSED CLINICAL SOCIAL WORK CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-771-4218
Mailing Address - Street 1:5819 ADELAIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-5420
Mailing Address - Country:US
Mailing Address - Phone:626-374-7549
Mailing Address - Fax:
Practice Address - Street 1:4283 EL CAJON BLVD STE 226
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1289
Practice Address - Country:US
Practice Address - Phone:619-771-4218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty