Provider Demographics
NPI:1225060874
Name:THE SUPPORT PROJECT, INC
Entity Type:Organization
Organization Name:THE SUPPORT PROJECT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-563-3294
Mailing Address - Street 1:3527 SACRAMENTO ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1884
Mailing Address - Country:US
Mailing Address - Phone:415-563-3294
Mailing Address - Fax:510-531-4764
Practice Address - Street 1:3527 SACRAMENTO ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1884
Practice Address - Country:US
Practice Address - Phone:415-563-3294
Practice Address - Fax:510-531-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 158381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ33489ZOtherBLUE SHIELD OF CA