Clark White Licensed Clinical Social Worker Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLARK WHITE LICENSED CLINICAL SOCIAL WORKER INC

Practice address

421 W Broadway Apt 4112
Long Beach, CA 90802-9430

Phone

(424) 261-8818

NPI assigned

Mar 7, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Keesha Clark, LCSWNPI 1710423397

Title

Ceo

Phone

(424) 261-8818

Specialties & licenses 1

Addresses

Other names 1

• Brighten Every Life Counseling Services Doing business as

Practitioners 1

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

• Keesha Clark, MSW

  • Social Worker
  • Long Beach, CA
  • NPI 1710423397
  NPD Authorized official

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1962260638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908010135",
            "telephone_number": "424-261-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W BROADWAY APT 4112",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908029430",
            "telephone_number": "424-261-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK WHITE LICENSED CLINICAL SOCIAL WORKER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-261-8818",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighten Every Life Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deorlean Claiborne, MSW
• Claire Liu MD Inc
• Catherine Frances Clancy, MFTI
• Magaly Clara Sanchez
• Morris Nathaniel Clardie Jr.
• Amber Shiori Clark
• April Calista Clark
• Carolyn Bentley Clark, RN
• Charles Curtis Clark, M.D.
• Dennis L Clark, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.