NPIMap

Organization Active NPI

Breaking Cycles Counseling

  • Clinical Social Worker
  • Grand Terrace, CA
National Provider Identifier
1972284958
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BREAKING CYCLES COUNSELING
Doing business as
Breaking Cycles Counseling
Practice address
12139 Mount Vernon Ave Ste 105
Grand Terrace, CA 92313-5500
Phone
(909) 222-0096
Fax
(840) 600-3050
NPI assigned
Jul 31, 2023
Last updated
May 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Kalisha Koran Brown, LCSWNPI 1396307070
Title
Ceo
Phone
(909) 222-0096

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

12139 Mount Vernon Ave Ste 105
Grand Terrace, CA 92313-5500

Mailing address

3010 S Dakota St
Pine Bluff, AR 71601-7208
Phone (870) 200-9393

Other practice location 1

600 Congress Ave Fl 14
Austin, TX 78701-3263
Phone (323) 205-7088

Other practice location 2

400 W Capitol Ave Ste 1700
Little Rock, AR 72201-3438
Phone (323) 205-7088

Other practice location 3

3010 S Dakota St
Pine Bluff, AR 71601-7208
Phone (909) 222-0096

Other practice location 4

901 N Glebe Rd Fl 5
Arlington, VA 22203-1853
Phone (323) 205-7088

Other identifiers 1

IdentifierTypeStateIssuer
100393986MedicaidCA

Other names 2

  • Breaking Cycles Counseling Doing business as
  • Breaking Cycles Counseling and Behavioral Health Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230911000920 CA Part B Supplier - Clinic/Group Practice 4082078027 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Terrace, CA

National Provider Directory

National Provider Directory

Locations

12139 Mount Vernon Ave
Ste 105
Grand Terrace, CA 92313
Phone (909) 219-5097

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1972284958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 S DAKOTA ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716017208",
            "telephone_number": "870-200-9393",
            "fax_number": "840-600-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12139 MOUNT VERNON AVE STE 105",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135500",
            "telephone_number": "909-222-0096",
            "fax_number": "840-600-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Congress Ave Fl 14",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787013263",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Capitol Ave Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722013438",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3010 S Dakota St",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716017208",
            "country_code": "US",
            "telephone_number": "909-222-0096",
            "fax_number": "840-600-3050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 N Glebe Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222031853",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BREAKING CYCLES COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KALISHA KORAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-222-0096",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100393986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breaking Cycles Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Breaking Cycles Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Breaking Cycles Counseling and Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.