Individual provider · Type 1 NPI

Stacy De Vries Bostrom, MSW

Clinical Social Worker · Escondido, CA

NPI number 1396875779 Active

Practice location

474 W Vermont Ave, Suite 103
Escondido, CA 92025-6584

Mailing address

930 Via Mil Cumbres, Unit 53
Solana Beach, CA 92075-1700

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

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 1396875779

Stacy De Vries Bostrom, MSW's National Provider Identifier is 1396875779, issued on Mar 6, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Escondido, CA. The record was last updated on Jul 8, 2007.