Triple Moon Psychotherapy Collective a Licensed Clinical Social Worker
NPI #1306587837 in Garden Grove, California
Provider Information
- NPI Number
- 1306587837
- Entity Type
- Organization
- Organization Name
- Triple Moon Psychotherapy Collective a Licensed Clinical Social Worker
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Apr 6, 2022
- Last Updated
- Oct 4, 2023
Practice Location
- Address
- 12371 LEWIS ST STE 103
- City
- Garden Grove
- State
- California
- ZIP Code
- 92840-4687
- Phone
- (949) 868-8255
Authorized Official
- Name
- AMY LE REVE RENDEROS, LMFT LPCC
- Title
- DIRECTOR
- Phone
- (951) 870-1528
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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