| Tl Licensed Clinical Social Worker Inc. | |
|
2222 Martin Suite 200 Irvine CA 92612-1458 | |
| (949) 444-2851 | |
| Not Available |
| Full Name | Tl Licensed Clinical Social Worker Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2222 Martin, Irvine, California |
| Authorized Official Name and Position | Jessica Erin Hamilton (CEO/PRESIDENT) |
| Authorized Official Contact | 9494442851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tl Licensed Clinical Social Worker Inc. Po Box 61693 Irvine CA 92602 Ph: (949) 444-2851 | Tl Licensed Clinical Social Worker Inc. 2222 Martin Suite 200 Irvine CA 92612-1458 Ph: (949) 444-2851 |
| NPI Number | 1972934289 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972934289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 29227 (California) | Primary |
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