Provider Demographics
NPI:1407501240
Name:RADICAL HOPE CENTER FOR PSYCHOTHERAPY, A CLINICAL PSYCHOLOGY AND LICEN
Entity Type:Organization
Organization Name:RADICAL HOPE CENTER FOR PSYCHOTHERAPY, A CLINICAL PSYCHOLOGY AND LICEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-902-9823
Mailing Address - Street 1:8735 SUMMER SUN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1297
Mailing Address - Country:US
Mailing Address - Phone:973-902-9823
Mailing Address - Fax:
Practice Address - Street 1:1508 F ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-1609
Practice Address - Country:US
Practice Address - Phone:973-902-9823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty