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Organization
MYNDLOFT LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Active
Organization
MYNDLOFT LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Active
Other names
mindloft, myndloft
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE ELERY WERNER PHD (ADMINISTRATOR)
(949) 569-9226
Entity
Organization
Contact information
Practice address
240 W CHAPMAN AVE STE 200, ORANGE, CA 92866-1316
(855) 750-5010
(619) 354-1803
Mailing address
PO BOX 3340, TUSTIN, CA 92781-3340
(855) 750-5010
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/06/2023
Last updated
05/03/2023
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