| Therapy In A Bag, Licensed Clinical Social Worker, Inc. | |
|
4164 Brockton Ave Riverside CA 92501-3400 | |
| (951) 347-6935 | |
| (951) 346-9175 |
| Full Name | Therapy In A Bag, Licensed Clinical Social Worker, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4164 Brockton Ave, Riverside, California |
| Authorized Official Name and Position | Lisa M Dryan (PRESIDENT THERAPY IN A BAG, A LICEN) |
| Authorized Official Contact | 9513476935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy In A Bag, Licensed Clinical Social Worker, Inc. Po Box 1403 Riverside CA 92502-1403 Ph: (951) 347-6935 | Therapy In A Bag, Licensed Clinical Social Worker, Inc. 4164 Brockton Ave Riverside CA 92501-3400 Ph: (951) 347-6935 |
| NPI Number | 1982182903 |
|---|---|
| Provider Enumeration Date | 08/01/2018 |
| Last Update Date | 10/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982182903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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