Provider Demographics
NPI:1922888759
Name:INNER HEALING THERAPY, A LICENSED CLINICAL SOCIAL WORKER P.C.
Entity Type:Organization
Organization Name:INNER HEALING THERAPY, A LICENSED CLINICAL SOCIAL WORKER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SILVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-933-1420
Mailing Address - Street 1:1125 E BROADWAY # 841
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1315
Mailing Address - Country:US
Mailing Address - Phone:818-748-9977
Mailing Address - Fax:
Practice Address - Street 1:1935 ALPHA ROAD UNIT 209
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208
Practice Address - Country:US
Practice Address - Phone:818-748-9977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty