Provider Demographics
NPI:1982312864
Name:INCLUSIVE REPRODUCTIVE HEALING A LICENSED CLINICAL SOCIAL WORKER CO
Entity Type:Organization
Organization Name:INCLUSIVE REPRODUCTIVE HEALING A LICENSED CLINICAL SOCIAL WORKER CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-568-2608
Mailing Address - Street 1:9921 CARMEL MOUNTAIN RD # 332
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2813
Mailing Address - Country:US
Mailing Address - Phone:619-568-2608
Mailing Address - Fax:619-415-8405
Practice Address - Street 1:3003 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2700
Practice Address - Country:US
Practice Address - Phone:619-568-2608
Practice Address - Fax:619-415-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty