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Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc
Adolescent and Children Mental Health Clinic/Center in Mckinleyville, California
NPI 1407546989

Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc is an Adolescent and Children Mental Health Clinic/Center based in Mckinleyville, CA and is specialized in Adolescent and Children Mental Health. Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc practices in Mckinleyville, CA. The NPI Number for Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc is 1407546989 and holds a License No. (California).

The current practice location address for Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc is 1776 Market Ave, Mckinleyville, CA and can be reached out via phone at 503-440-5924.

Location: 1776 Market Ave, Mckinleyville, CA, 95519-4209
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407546989
Provider Name
Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc
Credential
Provider Entity Type
Organization
Address
1776 Market Ave, Mckinleyville, CA, 95519-4209
Phone Number
503-440-5924
Fax Number
Provider Enumeration Date
05/09/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1776 Market Ave
City
Mckinleyville
State
California
Zip
95519-4209
Phone Number
503-440-5924
Fax Number
person
Provider Business Mailing Address Details
Address
1776 Market Ave
City
Mckinleyville
State
California
Zip
95519-4209
Phone Number
503-440-5924
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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