Provider Demographics
NPI:1275396434
Name:NURTURING MIND, BODY & SPIRIT, A CLINICAL SOCIAL WORKER, PROFESSIONAL
Entity Type:Organization
Organization Name:NURTURING MIND, BODY & SPIRIT, A CLINICAL SOCIAL WORKER, PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:YENI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:760-936-6182
Mailing Address - Street 1:2714 RUSTIC HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2766
Mailing Address - Country:US
Mailing Address - Phone:760-936-6182
Mailing Address - Fax:
Practice Address - Street 1:15200 HESPERIAN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-3927
Practice Address - Country:US
Practice Address - Phone:510-225-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty