NPIMap

Organization Active NPI

Whole Wellness Therapy, a Licensed Clinical Social Worker Corporation

  • Mental Health Counselor
  • Fair Oaks, CA
National Provider Identifier
1811536337
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WHOLE WELLNESS THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Practice address
4112 Pennsylvania Ave
Fair Oaks, CA 95628-7413
Phone
(916) 619-7744
Fax
(916) 581-8691
NPI assigned
Jan 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Authorized official

Name
Isaac SmithNPI 1275979072
Title
Ceo
Phone
(916) 619-3405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4112 Pennsylvania Ave
Fair Oaks, CA 95628-7413

Mailing address

4112 Pennsylvania Ave
Fair Oaks, CA 95628-7413
Phone (916) 619-3405

Other names 1

  • Whole Wellness Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1577836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1811536337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 PENNSYLVANIA AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287413",
            "telephone_number": "916-619-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 PENNSYLVANIA AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287413",
            "telephone_number": "916-619-7744",
            "fax_number": "916-581-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE WELLNESS THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-01",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-619-3405"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whole Wellness Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Whole Wellness Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.