Individual provider · Type 1 NPI

Jack Lew Gorham, LCSW

Clinical Social Worker · Los Angeles, CA

NPI number 1780947291 Active

Practice location

2500 Wilshire Blvd, 5th Floor
Los Angeles, CA 90057-4303

Call (619) 573-0469 Map

Mailing address

679 S New Hampshire Ave Ste 400
Los Angeles, CA 90005-1355

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Clinical Social Worker Primary 1041C0700XLCSW80419 (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 1780947291

Jack Lew Gorham, LCSW's National Provider Identifier is 1780947291, issued on Jun 19, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Los Angeles, CA. The record was last updated on Nov 20, 2017.