Individual provider · Type 1 NPI
Ethan C. Mandelkern
Clinical Social Worker · Mount Shasta, CA
Practice location
419 Chestnut St, Suite #2
Mount Shasta, CA 96067-2918
Fax (530) 918-5477
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | LPCC726 (CA) |
| Clinical Social Worker Primary | 1041C0700X | LCSW64679 (CA) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1023224623
Ethan C. Mandelkern's National Provider Identifier is 1023224623, issued on May 14, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Mount Shasta, CA. The record was last updated on Aug 12, 2024.