Individual provider · Type 1 NPI
Marisa Denise Medina, LCSW127143
Clinical Social Worker · Fontana, CA
Practice location
17343 Anastasia Ave
Fontana, CA 92335-4933
Mailing address
12813 Philadelphia St
Whittier, CA 90601-4118
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Clinical Social Worker Primary | 1041C0700X | LCSW127143 (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 1770757445
Marisa Denise Medina, LCSW127143's National Provider Identifier is 1770757445, issued on Apr 14, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fontana, CA. The record was last updated on Jan 16, 2025.