Provider Demographics
NPI:1609659937
Name:HEALTHY MINDS COUNSELING CENTER, LICENSED CLINICAL SOCIAL WORKER, PC
Entity Type:Organization
Organization Name:HEALTHY MINDS COUNSELING CENTER, LICENSED CLINICAL SOCIAL WORKER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTERREY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:925-663-8158
Mailing Address - Street 1:1120 2ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2225
Mailing Address - Country:US
Mailing Address - Phone:925-663-8158
Mailing Address - Fax:
Practice Address - Street 1:1120 2ND ST STE C
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2225
Practice Address - Country:US
Practice Address - Phone:925-663-8158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty