Individual provider · Type 1 NPI

Kenneth John De Haan, LCSW

Clinical Social Worker · San Pedro, CA

NPI number 1174643753 Active

Practice location

704 West 8th Street
San Pedro, CA 90731

Call (310) 832-7545 Map

Fax (310) 833-8580

Mailing address

704 W 8th St
San Pedro, CA 90731-3017

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	LCS13281 (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 1174643753

Kenneth John De Haan, LCSW's National Provider Identifier is 1174643753, issued on Mar 29, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in San Pedro, CA. The record was last updated on Jun 11, 2013.