Spirited by Truth Licensed Clinical Social Worker Corportation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPIRITED BY TRUTH LICENSED CLINICAL SOCIAL WORKER CORPORTATION

Practice address

3400 Inland Empire Blvd Ste 101
Ontario, CA 91764-5577

Phone

(909) 312-0552

NPI assigned

Nov 8, 2019

Organization subpart

No

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

Authorized official

Name

Alexandra Samuel-Sturgess, LCSW

Title

Ceo

Phone

(909) 312-0552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1417592916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 INLAND EMPIRE BLVD STE 101",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645577",
            "telephone_number": "909-312-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 INLAND EMPIRE BLVD STE 101",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645577",
            "telephone_number": "909-312-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRITED BY TRUTH LICENSED CLINICAL SOCIAL WORKER CORPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "SAMUEL-STURGESS",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-312-0552",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ontario, CA
• Providers in Ontario, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.