Provider Demographics
NPI:1609552678
Name:CRIY -CULTIVATING RESILIENCE IN YOU THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:CRIY -CULTIVATING RESILIENCE IN YOU THERAPEUTIC SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:916-884-0607
Mailing Address - Street 1:8976 NEPONSET DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624
Mailing Address - Country:US
Mailing Address - Phone:916-884-0607
Mailing Address - Fax:
Practice Address - Street 1:725 30TH ST STE 209
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3842
Practice Address - Country:US
Practice Address - Phone:916-884-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77673OtherLCSW