Individual
AUDREY KAY COSTA
Active
Individual
AUDREY KAY COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCSW1114
CA
101YM0800X
Mental Health Counselor
LCSW111480
CA
104100000X
Social Worker
LCSW111480
CA
1041C0700X
Clinical Social Worker
Primary
LCSW111480
CA
Other
Enumeration date
07/23/2019
Last updated
01/26/2024
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