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Organization
PROSPERA MHW INC.
Active
Organization
PROSPERA MHW INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA NICOLE NILES PHD (CEO)
(415) 407-0988
Entity
Organization
Contact information
Practice address
3249 MARLENE DR, LAFAYETTE, CA 94549-4723
(415) 407-0988
Mailing address
2120 CONTRA COSTA BLVD # 1155, PLEASANT HILL, CA 94523-3742
(415) 407-0988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
171400000X
Health & Wellness Coach
Primary
—
NULL
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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