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WINGS OF THE FUTURE PRIVATE PRACTICE LICENSED CLINICAL WORKER PC NPI 1649944430


NPI Information

NPI: 1649944430
Provider Name: WINGS OF THE FUTURE PRIVATE PRACTICE LICENSED CLINICAL WORKER PC

Doing Business As: WINGS OF THE FUTURE CONSULTING PRIVATE PRACTICE

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1050 LAKES DR STE 225
WEST COVINA, CA
ZIP 91790
Phone: (661) 402-1545
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WINGS OF THE FUTURE PRIVATE PRACTICE LICENSED CLINICAL WORKER PC is a clinical social worker in West Covina, CA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. WINGS OF THE FUTURE PRIVATE PRACTICE LICENSED CLINICAL WORKER PC NPI is 1649944430. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wings Of The Future Consulting Private Practice.

The provider's business location address is:

1050 LAKES DR STE 225
WEST COVINA, CA
ZIP 91790-910
Phone: (661) 402-1545
Fax: (661) 727-0006

The provider's authorized official is Krystal Marie Boothe .
The authorized official title is Ceo/executive Director and has the following contact phone number (661) 402-1545.

The enumeration date for this NPI number is 8/4/2021 and was last updated on 10/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
183-2422898OTHERCALIFORNIAIRS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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