Provider Demographics
NPI:1306536743
Name:EMPATIA COUNSELING SERVICES A LICENSED CLINICAL SOCIAL WORKER CO
Entity type:Organization
Organization Name:EMPATIA COUNSELING SERVICES A LICENSED CLINICAL SOCIAL WORKER CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:SIGUENZA
Authorized Official - Last Name:LIZARDE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-640-9256
Mailing Address - Street 1:4401 ATLANTIC AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2264
Mailing Address - Country:US
Mailing Address - Phone:213-640-9256
Mailing Address - Fax:562-685-0459
Practice Address - Street 1:4401 ATLANTIC AVE STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2264
Practice Address - Country:US
Practice Address - Phone:213-640-9256
Practice Address - Fax:562-685-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty