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Organization
DEEPLY ROOTED COUNSELING & WELLNESS CENTER
Active
Organization
DEEPLY ROOTED COUNSELING & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHADARIA R PRINCE LCSW (LICENSED CLINICAL SOCIAL WORKER)
(310) 654-9835
Entity
Organization
Contact information
Practice address
2600 VENTURA ST STE 110, FRESNO, CA 93721-3041
(310) 654-9835
Mailing address
4183 W WELDON AVE, FRESNO, CA 93722-6893
(310) 654-9835
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
07/07/2023
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