Organization
WOMEN'S THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PERRY (EXECUTIVE DIRECTOR)
(510) 524-4822
Entity
Organization
Contact information
Practice address
2105 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704-1108
(510) 524-4822
(510) 524-8292
Mailing address
2105 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704-1108
(510) 524-4822
(510) 524-8292
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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