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Organization
LIVEWELL THERAPY, INC.
Active
Organization
LIVEWELL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA CHAN LCSW (CEO)
(909) 539-0085
Entity
Organization
Contact information
Practice address
5861 PINE AVE., CHINO HILLS, CA 91709
(909) 539-0085
Mailing address
14071 PEYTON DRIVE UNIT 1504, CHINO HILLS, CA 91709
(909) 539-0085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCS24739
CA
103K00000X
Behavior Analyst
LCS24739
CA
1041C0700X
Clinical Social Worker
Primary
LCS24739
CA
1041S0200X
School Social Worker
LCS24739
CA
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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