Therapy for Black Women

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

THERAPY FOR BLACK WOMEN

Practice address

5353 Baltimore Dr
La Mesa, CA 91942-4607

Phone

(619) 784-4978

NPI assigned

Jan 17, 2023

Organization subpart

No

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

Authorized official

Name

Jerisha Lacrae Rutlin, LPCCNPI 1710498167

Title

Owner

Phone

(619) 784-4978

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jerisha Lacrae Rutlin, LPC, NCC

  • Mental Health Counselor
  • Maryland Heights, MO
  • NPI 1710498167
  NPD Authorized official

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1720793565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 BALTIMORE DR APT 31",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919425019",
            "telephone_number": "314-625-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALTIMORE DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919424607",
            "telephone_number": "619-784-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY FOR BLACK WOMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "RUTLIN",
        "authorized_official_first_name": "JERISHA",
        "authorized_official_middle_name": "LACRAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-784-4978",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.