Provider Demographics
NPI:1225570161
Name:DAVIDA SHREIBER LICENSED CLINICAL SOCIAL WORKER INC
Entity Type:Organization
Organization Name:DAVIDA SHREIBER LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:NORTH COUNTY COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-519-7116
Mailing Address - Street 1:PO BOX 230692
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-0692
Mailing Address - Country:US
Mailing Address - Phone:760-519-7116
Mailing Address - Fax:
Practice Address - Street 1:700 GARDEN VIEW CT
Practice Address - Street 2:201G
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2478
Practice Address - Country:US
Practice Address - Phone:760-519-7116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS293101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty