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Individual
SAMUEL CLEMENS
Active
Individual
SAMUEL CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-39917
ID
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/26/2020
Last updated
12/30/2025
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