Organization
CLINICAL SOCIAL WORK SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN JO BOURG LCSW (PARTNER)
(409) 724-1920
Entity
Organization
Contact information
Practice address
3005 AVENUE H, NEDERLAND, TX 77627-7607
(409) 724-1920
(409) 724-1102
Mailing address
3005 AVENUE H, NEDERLAND, TX 77627-7607
(409) 724-1920
(409) 724-1102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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