Organization · NPI-2

3rd Street Youth Center & Clinic

Counselor, Mental Health · San Francisco, CA

NPI number1912504929

StatusActive

Last updated in NPPESOct 2, 2020

Details

NPI: 1912504929
Entity type: Organization (NPI-2)
Legal business name: 3rd Street Youth Center & Clinic
Organization subpart: No
Enumeration date: Oct 2, 2020
Certification date: Oct 2, 2020
Last updated: Oct 2, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	–	–	Yes
1041C0700X	Social Worker, Clinical	–	–
106H00000X	Marriage & Family Therapist	–	–

Practice location

1728 Bancroft Ave
San Francisco, CA 94124-2697

Phone 415-877-1707 · Fax 415-822-1723

Mailing address

1728 Bancroft Ave
San Francisco, CA 94124-2697

Phone 415-877-1707 · Fax 415-822-1723

Authorized official

Joi Jackson-Morgan
Executive Director
4158771707

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