Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN C MANDELKERN
Active Sole ProprietorETHAN C MANDELKERN is a Clinical Social Worker healthcare provider located in MOUNT SHASTA, California. NPI 1023224623 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · MOUNT SHASTA, CA
Registration Details
- NPI Number
- 1023224623
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 14, 2007 (19.22651687201 yrs)
- Last Updated
- Aug 12, 2024
- Licenses
-
LPCC726 (CA)LCSW64679 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
419 CHESTNUT STSUITE #2MOUNT SHASTA, CA, 960672918Browse CA providers · Browse ZIP 96067
- Phone
- 5309188348
- Fax
- 5309185477
- Primary Specialty
-
Clinical Social Worker
1041C0700X
- Additional Specialty
- Clinical Social Worker
Other Clinical Social Worker Providers in MOUNT SHASTA, CA
| Name | Credential | NPI |
|---|---|---|
| MS. CANDACE A ROSS | MSW, LCSW, MAC, CCTP | 1467549212 |
| MRS. JANET LEE RAINVILLE | LCSW | 1245446855 |
| MR. STANTON M DRUCKER | LCSW | 1063621308 |
| CAROL JENKINS | — | 1639495153 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.