Provider Demographics
NPI:1801254958
Name:THERAPY ASSOCIATES CLINICAL SERVICES INC
Entity type:Organization
Organization Name:THERAPY ASSOCIATES CLINICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LORN
Authorized Official - Last Name:BAUDIZZON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-241-9276
Mailing Address - Street 1:1933 MARKET ST STE C
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1929
Mailing Address - Country:US
Mailing Address - Phone:530-241-9276
Mailing Address - Fax:530-241-0114
Practice Address - Street 1:1933 MARKET ST
Practice Address - Street 2:C
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1929
Practice Address - Country:US
Practice Address - Phone:530-241-9276
Practice Address - Fax:530-241-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 17258251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health