| Clark White Licensed Clinical Social Worker Inc | |
|
421 W Broadway Apt 4112 Long Beach CA 90802-9430 | |
| (424) 261-8818 | |
| Not Available |
| Full Name | Clark White Licensed Clinical Social Worker Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 421 W Broadway Apt 4112, Long Beach, California |
| Authorized Official Name and Position | Keesha Clark (CEO) |
| Authorized Official Contact | 4242618818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark White Licensed Clinical Social Worker Inc Po Box 135 Long Beach CA 90801-0135 Ph: (424) 261-8818 | Clark White Licensed Clinical Social Worker Inc 421 W Broadway Apt 4112 Long Beach CA 90802-9430 Ph: (424) 261-8818 |
| NPI Number | 1962260638 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962260638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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