Provider Demographics
NPI:1790822955
Name:INDIVIDUALS NOW, INC
Entity Type:Organization
Organization Name:INDIVIDUALS NOW, INC
Other - Org Name:SOCIAL ADVOCATES FOR YOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELING SERVICES PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:707-800-3947
Mailing Address - Street 1:2447 SUMMERFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405
Mailing Address - Country:US
Mailing Address - Phone:707-544-3299
Mailing Address - Fax:707-544-6837
Practice Address - Street 1:2447 SUMMERFIELD ROAD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405
Practice Address - Country:US
Practice Address - Phone:707-544-3299
Practice Address - Fax:707-544-6837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110000058261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health