Provider Demographics
NPI:1437959608
Name:COMMUNAL HEALING LICENSED CLINICAL SOCIAL WORKER CORPORATION
Entity type:Organization
Organization Name:COMMUNAL HEALING LICENSED CLINICAL SOCIAL WORKER CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TANYX
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN-MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-207-6206
Mailing Address - Street 1:1525 N ALVARADO ST UNIT 26057
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-7404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 HILLHURST AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2012
Practice Address - Country:US
Practice Address - Phone:213-207-6206
Practice Address - Fax:323-916-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty