OrganizationActive
Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc
NPI 1407546989 · Mental Health Clinic/Center (Including Community Mental Health Center) · Mckinleyville, CA
Provider details
- NPI number
- 1407546989
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bo Hamer, Ceo - Clinical Director(503) 440-5924
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
1776 Market Ave
Mckinleyville, CA 95519-4209
Phone: (503) 440-5924
Approximate (ZIP-level) locationGet directions
Mailing address
1776 Market Ave
Mckinleyville, CA 95519-4209
Registry dates
- Enumerated
- 2023-05-09
- Last updated
- 2023-05-10
- Certified
- 2023-05-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.