Grey Space Therapy, LCSW Professional Corporation
Grey Space Therapy, LCSW Professional Corporation is a Mental Health Counselor in Riverside, California. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 4
Practice location Address checks out
5055 Canyon Crest Dr Ste 216Riverside, CA 92507-6015
Phone: (714) 749-5554
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Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X |
|---|---|
| Mental Health Counselor | Taxonomy 101YM0800X |
| Professional Counselor | Taxonomy 101YP2500X |
| Marriage & Family Therapist | Taxonomy 106H00000X |
Record details
| NPI number | 1174238190 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Fabiola Pacheco — Founder · (714) 749-5554 |
| NPI enumerated | January 16, 2023 |
| Last updated in NPPES | January 16, 2023 |
| Certification date | January 14, 2023 |
| Mailing address | 5744 Crest Ave, Riverside, CA 92503-8634 |
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Johnnie Ray Gray Jr.
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MS. Lori Green, MHRS
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MS. Lynn Marie Green
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Allyson E Greenwood, AMFT
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Dan Grimaldi
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