Provider Demographics
NPI:1861026080
Name:URBAN CATALYST PSYCHOTHERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPOR
Entity Type:Organization
Organization Name:URBAN CATALYST PSYCHOTHERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GADSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-909-1487
Mailing Address - Street 1:1700 NORBRIDGE AVE # G
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5700
Mailing Address - Country:US
Mailing Address - Phone:510-698-1100
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST STE 308
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3548
Practice Address - Country:US
Practice Address - Phone:510-698-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty