Edmond Child and Family Counseling, Clark D Edmond, Licensed Clinical

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

EDMOND CHILD AND FAMILY COUNSELING, CLARK D EDMOND, LICENSED CLINICAL

Practice address

41690 Ivy St Ste B6
Murrieta, CA 92562-9436

Phone

(951) 676-5154

Fax

(951) 526-1015

NPI assigned

Oct 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clark David Edmond, LCSWNPI 1457651150

Title

Ceo

Phone

(951) 775-0032

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clark David Edmond, LCSW

  • Clinical Social Worker
  • Murrieta, CA
  • NPI 1457651150
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634947200000",
    "number": "1851055123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40960 CALIFORNIA OAKS RD # 220",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625747",
            "telephone_number": "951-676-5154",
            "fax_number": "951-516-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41690 IVY ST STE B6",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629436",
            "telephone_number": "951-676-5154",
            "fax_number": "951-526-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND CHILD AND FAMILY COUNSELING, CLARK D EDMOND, LICENSED CLINICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-23",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-23",
        "status": "A",
        "authorized_official_last_name": "EDMOND",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-775-0032",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://doxy.me/clarkedmondlcsw",
            "affiliation": "N",
            "endpointDescription": "I use an encrypted website for Telehealth that is HIPPA compliant in which I can receive and transmit protected health information.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Documents: pdf, jpeg, jpg, dox, docx, png, ppt, pptx, xlsx",
            "address_1": "41690 Ivy St Ste B6",
            "city": "Murrieta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925629436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christian Miles Ebuen
• Ecie Anesthesia LLC
• Jenna Raquel Eckstein
• Breelin Ashley Eddy
• Luke Edgson
• Clark David Edmond, LCSW
• Jeffrey William Edmunds, D.O., M.S., R.D.
• Thelma I Edquid, M.D.
• Annabelle Abayan Edquilang, RNFA
• Cecil Edwards, LCSW

• Social Worker in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.