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Organization
KELLI CLARK LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Active
Organization
KELLI CLARK LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Active
Other names
Kelli Clark, LCSW, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JULIO LAGOS LCSW (OPERATIONS)
(415) 562-4156
Entity
Organization
Contact information
Practice address
3150 18TH ST STE 350, SAN FRANCISCO, CA 94110-2077
(415) 562-4156
(415) 952-9565
Mailing address
3150 18TH ST STE 350, MAILBOX#202, SAN FRANCISCO, CA 94110-2075
(415) 562-4156
(415) 952-9565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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