Manda Selva, Licensed Clinical Social Worker, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MANDA SELVA, LICENSED CLINICAL SOCIAL WORKER, INC

Doing business as

mandala counseling

Practice address

631 La Paloma Rd
El Sobrante, CA 94803-1735

Phone

(510) 230-9565

NPI assigned

Aug 15, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Madhulla Selva

Title

President

Phone

(510) 230-9565

Specialties & licenses 2

Addresses

Other names 1

• mandala counseling Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manda Selva, LCSW

  • Clinical Social Worker
  • El Sobrante, CA
  • NPI 1306084546
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1356124234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 APPIAN WAY",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642242",
            "telephone_number": "510-230-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LA PALOMA RD",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948031735",
            "telephone_number": "510-230-9565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2646 Appian Way Ste 12",
            "address_purpose": "LOCATION",
            "city": "Pinole",
            "state": "CA",
            "postal_code": "945642243",
            "country_code": "US",
            "telephone_number": "510-230-9565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MANDA SELVA, LICENSED CLINICAL SOCIAL WORKER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-05-28",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "SELVA",
        "authorized_official_first_name": "MADHULLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-230-9565"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mandala counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis Javier Magana Buenrostro
• Cynthia Magana
• Arturo Mancheno, D.C.
• Michael Ray Anastacio Mancio
• Jordan Elizabeth Mancuso
• Claudia Adriana Martinez
• Wayne Matecki, L. AC.
• Victoria McAfee
• Taylor Yvonne McEachin
• Michael Joseph McSweeney

• Mental Health Clinic/Center (Including Community Mental Health Center) in El Sobrante, CA
• Providers in El Sobrante, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.