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Contact Information

GENUINE DBT LICENSED CLINICAL SOCIAL WORKER INC
1140 MANGROVE AVE STE D
CHICO, CA95926
 Phone: 530-591-5915
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for GENUINE DBT LICENSED CLINICAL SOCIAL WORKER INC

NPI # 1902285208
LBN Legal business name GENUINE DBT LICENSED CLINICAL SOCIAL WORKER INC
Authorized official MICHAEL COURTER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2015
Last updated 11/03/2018 - About 8 years ago
Identifiers
CA License # 87407
CA License # LCSW61303
CA License # PSY26985
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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