Provider Demographics
NPI:1275292179
Name:BELONGING & HEALING THERAPY LICENSED CLINICAL SOCIAL WORKER INC
Entity Type:Organization
Organization Name:BELONGING & HEALING THERAPY LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:BELONGING & HEALING THERAPY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCNEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-302-0925
Mailing Address - Street 1:PO BOX 7698
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-0698
Mailing Address - Country:US
Mailing Address - Phone:909-302-0925
Mailing Address - Fax:
Practice Address - Street 1:308 W STATE ST STE 3D
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4653
Practice Address - Country:US
Practice Address - Phone:909-302-0925
Practice Address - Fax:909-247-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)