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Individual

CAL KLINGENSMITH SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
142 E 27TH ST SUITE 1A, NEW YORK, NY 10016-9057
(929) 259-2059
Mailing address
142 E 27TH ST APT 1A, NEW YORK, NY 10016-9057
(929) 259-2059

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
086888
NY
1041C0700X
Clinical Social Worker
Primary
083627
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03517411
NY
Enumeration date
11/03/2012
Last updated
08/05/2021
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