Provider Demographics
NPI:1932437365
Name:THE GIRLS' EMPOWERMENT CENTER
Entity Type:Organization
Organization Name:THE GIRLS' EMPOWERMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:DORIS
Authorized Official - Last Name:BUCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS MFT
Authorized Official - Phone:805-341-5735
Mailing Address - Street 1:143 TRIUNFO CANYON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2514
Mailing Address - Country:US
Mailing Address - Phone:805-341-5735
Mailing Address - Fax:
Practice Address - Street 1:143 TRIUNFO CANYON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2514
Practice Address - Country:US
Practice Address - Phone:805-341-5735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30759251S00000X
CA50015251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health