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Organization
LIVECONSCIOUS THERAPY, INC
Active
Organization
LIVECONSCIOUS THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SU BOUDREAU (PRESIDENT)
(858) 225-0888
Entity
Organization
Contact information
Practice address
2108 N ST STE N, SACRAMENTO, CA 95816-5712
(858) 225-0888
Mailing address
2108 N ST STE N, SACRAMENTO, CA 95816-5712
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
Other
Enumeration date
05/19/2025
Last updated
05/21/2025
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